40 results on '"Yih-Jyh Lin"'
Search Results
2. Real-world outcome of immune checkpoint inhibitors for advanced hepatocellular carcinoma with macrovascular tumor thrombosis
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Shih-Chieh Chien, Chiung Yu Chen, Hong Ming Tsai, I-Chin Wu, Chiao-Hsiung Chuang, Yih Jyh Lin, Hsin-Yu Kuo, Hung-Chih Chiu, Pin-Nan Cheng, Po-Jun Chen, Ting-Tsung Chang, Meng-Zhi Han, Jui-Wen Kang, and Yen-Cheng Chiu
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Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Hepatocellular carcinoma ,medicine.medical_treatment ,Immunology ,Inferior vena cava ,Macrovascular invasion ,Metastasis ,Immune checkpoint inhibitors ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,Adverse effect ,Aged ,Retrospective Studies ,Response rate (survey) ,Portal Vein ,business.industry ,Liver Neoplasms ,Thrombosis ,Immunotherapy ,Prognosis ,medicine.disease ,Survival Rate ,medicine.vein ,030220 oncology & carcinogenesis ,Original Article ,030211 gastroenterology & hepatology ,business ,Tyrosine kinase ,Follow-Up Studies - Abstract
Programmed cell death protein-1 (PD-1) inhibitors have shown promising results for treating advanced hepatocellular carcinoma (HCC). However, the clinical utility of such inhibitors in HCC patients with vascular tumor thrombosis remains unclear. This study investigated PD-1 inhibitor efficacy in advanced HCC with macrovascular invasion in a clinical setting. Among the 110 patients with unresectable HCC treated with PD-1 inhibitors, 34 patients with vascular metastases in the portal vein and inferior vena cava were retrospectively compared with 34 patients without tumor thrombi. The vascular response and its effect on survival were assessed. Predictors of survival were identified using multivariate analysis. Among patients achieving objective response, those with and without thrombi exhibited similar response to immunotherapy and comparable survival. Among the 34 patients with tumor thrombi, including 13 receiving PD-1 inhibitors alone and 21 receiving it in combination with tyrosine kinase inhibitors, the median overall survival was 8.9 months (95% confidence interval 3.2–12.6). The objective response rate of vascular metastasis was 52.9%, and vascular responders had a significantly longer survival than did non-responders (11.1 vs 3.9 months). Failure to obtain a vascular response correlated significantly with increased post-treatment Child–Pugh score or class. Multivariate analysis showed that vascular response was a significant positive factor for longer overall survival. Treatment-related grade 3/4 adverse events occurred in 3 (8.8%) of the patients with tumor thrombi. Immunotherapy with PD-1 inhibitors may be a feasible treatment option for HCC with tumor thrombi owing to the high response rate of tumor thrombi and favorable survival outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s00262-020-02845-9.
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- 2021
3. Impact of Immune Checkpoint Inhibitors with or without a Combination of Tyrosine Kinase Inhibitors on Organ-Specific Efficacy and Macrovascular Invasion in Advanced Hepatocellular Carcinoma
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Nai-Jung Chiang, Chiung Yu Chen, Hong Ming Tsai, Chiao-Hsiung Chuang, Ting-Tsung Chang, I-Chin Wu, Yih Jyh Lin, and Hsin-Yu Kuo
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Male ,Oncology ,Cancer Research ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Programmed Cell Death 1 Receptor ,ECOG Performance Status ,03 medical and health sciences ,Antineoplastic Agents, Immunological ,0302 clinical medicine ,Internal medicine ,Antineoplastic Combined Chemotherapy Protocols ,Tumor Microenvironment ,medicine ,Humans ,Neoplasm Invasiveness ,030212 general & internal medicine ,Protein Kinase Inhibitors ,Survival analysis ,Aged ,Retrospective Studies ,Response rate (survey) ,Tumor microenvironment ,business.industry ,Liver Neoplasms ,Cell Cycle Checkpoints ,Hematology ,Immunotherapy ,Middle Aged ,medicine.disease ,Survival Analysis ,Progression-Free Survival ,Treatment Outcome ,Response Evaluation Criteria in Solid Tumors ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,business ,Tyrosine kinase - Abstract
Introduction: The tumor microenvironments of different organs often differ and thus may affect the immunotherapy response. Objective: This study elucidated that the efficacy of programmed cell death protein-1 (PD-1) inhibitors varies across different metastatic sites among individuals with advanced hepatocellular carcinoma (HCC). Methods: We retrospectively analyzed treatment outcomes in advanced HCC patients receiving PD-1 inhibitors with or without a combination of tyrosine kinase inhibitors (TKIs). Both the overall response rate (ORR) and organ-specific response rate (OSRR) were assessed using Response Evaluation Criteria in Solid Tumors 1.1 criteria. A survival analysis and its predictors were determined using a multivariate analysis. Results: We analyzed 42 advanced HCC patients (median age: 58.0 years; 78.6% males). Thirty (71.4%) patients were sorafenib-experienced and 27 (64.3%) were administered a combination of TKIs. The ORR was 14.3% and the disease control rate was 33.3%. The median overall survival (OS) and progression-free survival (PFS) were 12.0 and 2.9 months, respectively. The OSRRs were 14.7, 23.8, 28.6, and 50.0% for the liver, lungs, lymph nodes, and vascular response, respectively. The multivariate analysis indicated that the vascular response was significantly associated with PFS. ECOG performance status was a significant independent predictor of OS. Conclusions: PD-1 inhibitors improved OS and PFS in advanced HCC patients. Their efficacies varied among the metastatic locations regardless of the combination of TKIs; in particular, a higher response in vascular metastases was correlated with a longer PFS. PD-1 inhibitors may deliver a synergistic benefit in patients undergoing traditional therapy and progression in other organs in vascular responders.
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- 2020
4. Adjuvant versus Neoadjuvant Immunotherapy for Hepatocellular Carcinoma: Clinical and Immunologic Perspectives
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Chia Chen Li, Chiun Hsu, Yung Yeh Su, and Yih Jyh Lin
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Oncology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Hepatology ,business.industry ,medicine.medical_treatment ,Liver Neoplasms ,Cancer ,Immunotherapy ,medicine.disease ,Systemic therapy ,Combined Modality Therapy ,Neoadjuvant Therapy ,Review article ,Hepatocellular carcinoma ,Internal medicine ,Adjuvant therapy ,Medicine ,Humans ,business ,Adjuvant ,Neoadjuvant therapy - Abstract
Advancement in systemic therapy, particularly immune checkpoint inhibitor (ICI)-based combination regimens, has transformed the treatment landscape for patients with advanced hepatocellular carcinoma (HCC). The advancement in systemic therapy also provides new opportunities of reducing recurrence after curative therapy through adjuvant therapy or improving resectability through neoadjuvant therapy. Improved recurrence-free survival by adjuvant or neoadjuvant ICI-based therapy has been reported in other cancer types. In this article, developments of systemic therapy in adjuvant and neoadjuvant settings for HCC were reviewed. The design of adjuvant and neoadjuvant therapy using ICI-based regimens and potential challenges of trial conduct and result analysis was discussed. Results from these trials may extend the therapeutic benefit of ICI-based systemic therapy beyond the advanced-stage disease and lead to a new era of multidisciplinary management for HCC.
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- 2021
5. Urine biomarker: novel approach to hepatocellular carcinoma screening
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Michael Goggins, Chi Tan Hu, Selena Y. Lin, Tai Jung Lee, Ying Hsiu Su, Harry Luu, Jeremy Wang, James P. Hamilton, Terence P. Gade, Yih Jyh Lin, Grace Park, Surbhi Jain, Hie-Won Hann, Dion Chen, Wei Song, Ting-Tsung Chang, Amy K. Kim, and Yue Lou
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Hepatitis ,medicine.medical_specialty ,Cirrhosis ,business.industry ,Biomarker panel ,Urine ,medicine.disease ,Gastroenterology ,digestive system diseases ,GSTP1 ,Internal medicine ,Hepatocellular carcinoma ,Cancer screening ,medicine ,Biomarker (medicine) ,business ,neoplasms - Abstract
Background & AimsContinued limitations in hepatocellular carcinoma (HCC) screening have led to late diagnosis with poor survival, despite well-defined high-risk patient populations. Our aim is to develop a non-invasive urine circulating tumor DNA (ctDNA) biomarker panel for HCC screening to aid in early detection.MethodsCandidate ctDNA biomarkers was prescreened in urine samples obtained from HCC, cirrhosis, and hepatitis patients. Then, 609 patient urine samples with HCC, cirrhosis, or chronic hepatitis B were collected from five academic medical centers and evaluated by serum alpha feto-protein (AFP) and urine ctDNA panel using logistic regression, a Two-Step machine learning algorithm, and iterated 10-fold cross-validation.ResultsMutated TP53, and methylated RASSF1a and GSTP1, were selected for the urine ctDNA panel. The sensitivity of AFP-alone (9.8 ng/mL cut-off) to detect HCC was 71% by Two-Step. The combination of ctDNA and AFP increased the sensitivity to 81% at a specificity of 90%. The AUROC for the combination of ctDNA and AFP vs. AFP-alone were 0.925 (95% CI, 0.924-0.925) and 0.877 (95% CI, 0.876-0.877), respectively. Notably, among the patients with AFP ConclusionsThe combination of urine ctDNA and serum AFP can increase HCC detection rates including in those patients with low-AFP. Given the ease of collection, a urine ctDNA panel could be a potential non-invasive HCC screening test.
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- 2020
6. Comparison of anatomic and non-anatomic resections for very early-stage hepatocellular carcinoma: The importance of surgical resection margin width in non-anatomic resection
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Tsung Han Yang, Yih Jyh Lin, Che Min Su, and Chung Ching Chou
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Male ,medicine.medical_specialty ,Surgical margin ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,03 medical and health sciences ,0302 clinical medicine ,Margin (machine learning) ,medicine ,Hepatectomy ,Humans ,Stage (cooking) ,Anatomic resection ,Aged ,Retrospective Studies ,business.industry ,Liver Neoplasms ,Margins of Excision ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Prognosis ,Survival Rate ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,030211 gastroenterology & hepatology ,Surgery ,Female ,Radiology ,Liver function ,business ,Follow-Up Studies - Abstract
Background The superiority of anatomic resection (AR) over non-anatomic resection (NAR) for very early-stage hepatocellular carcinoma (HCC) has remained a topic of debate. Thus, this study aimed to compare the prognosis after AR and NAR for single HCC less than 2 cm in diameter. Methods Consecutive patients with single HCC of diameter less than 2 cm who underwent curative hepatectomy between 1997 and 2017 were included in this retrospective study. Results In total, 159 patients were included in this study. Of these, 52 patients underwent AR (AR group) and 107 patients underwent NAR (NAR group). No significant differences were noted in recurrence-free survival (RFS) and overall survival (OS) between the AR and NAR groups (P = 0.236 and P = 0.363, respectively). Multivariate analysis revealed that low preoperative platelet count and presence of satellite nodules were independent prognostic factors of RFS and OS. Wide surgical resection margin did not affect RFS (P = 0.692) in the AR group; however, in the NAR group, RFS was found to be higher with surgical resection margin widths ≥1 cm than with surgical resection margin widths Conclusions Prognosis was comparable between the NAR and AR groups for very early-stage HCC with well-preserved liver function. For better oncologic outcomes, surgeons should endeavor in keeping the surgical resection margin widths during NAR ≥1 cm.
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- 2020
7. Treatment patterns and survival in hepatocellular carcinoma in the United States and Taiwan
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Yih Jyh Lin, Sylvia H. Hsu, Cary P. Gross, Jung-Der Wang, Chia-Ni Lin, Tannaz Sedghi, and Shi-Yi Wang
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Male ,Cirrhosis ,Cancer Treatment ,Social Sciences ,Gastroenterology ,Cohort Studies ,Geographical Locations ,0302 clinical medicine ,Medicine and Health Sciences ,Stage (cooking) ,Aged, 80 and over ,Multidisciplinary ,Liver Diseases ,Liver Neoplasms ,Survival Rate ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Medicine ,030211 gastroenterology & hepatology ,Female ,Cohort study ,Research Article ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Asia ,Science ,Political Science ,Taiwan ,Public Policy ,Gastroenterology and Hepatology ,Stage ii ,Medicare ,03 medical and health sciences ,Diagnostic Medicine ,Internal medicine ,Gastrointestinal Tumors ,medicine ,Carcinoma ,Cancer Detection and Diagnosis ,Humans ,Survival rate ,Survival analysis ,Aged ,business.industry ,Cancers and Neoplasms ,Hepatocellular Carcinoma ,medicine.disease ,Survival Analysis ,United States ,People and Places ,business - Abstract
BackgroundSurvival in hepatocellular carcinoma (HCC) is lower in the USA than in Taiwan. Little is known about the extent to which differences in stage at diagnosis and treatment contribute to this difference. We examined treatment patterns and survival in HCC and analyzed factors driving the difference.MethodsUsing a uniform methodology, we identified patients aged 66 years and older with newly diagnosed HCC between 2004 and 2011 in the USA and Taiwan. We compared treatment within 6 months after HCC diagnosis and 2-year stage-specific survival between the two countries.ResultsCompared with patients in Taiwan (n = 32,987), patients in the USA (n = 7,003) were less likely to be diagnosed as stage IA (4% vs 8%) and II (13% vs 22%), or receive cancer-directed treatments (41% vs 58%; all p < .001). Stage-specific 2-year survival rates were lower in the USA than in Taiwan (stage IA: 57% vs 77%; stage IB: 38% vs 63%; stage II: 40% vs 57%, stage III: 14% vs 18%; stage IV: 4% vs 5%, respectively; all p < .001 except p = .018 for stage IV). Differences in age and sex (combined), stage, and receipt of treatment accounted for 3.8%, 17.0%, and 16.8% of the survival difference, respectively, leaving 62.5% unexplained.ConclusionsDifferential stage at diagnosis and treatment were substantially associated with the survival difference, but approximately two-thirds of the difference remained unexplained. Identifying the main drivers of the difference could help improve HCC survival in the USA.
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- 2020
8. Combined Transarterial Embolization/Chemoembolization-Based Locoregional Treatment with Sorafenib Prolongs the Survival in Patients with Advanced Hepatocellular Carcinoma and Preserved Liver Function: A Propensity Score Matching Study
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Hong Chi Chiu, Yih Jyh Lin, Shih Chieh Chien, Yi Shan Liu, Chiung Yu Chen, Yen-Cheng Chiu, Chiao-Hsiung Chuang, Ting-Tsung Chang, Hsiu Chi Cheng, and Pin-Nan Cheng
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Sorafenib ,Original Paper ,medicine.medical_specialty ,Hepatology ,business.industry ,Standard treatment ,medicine.disease ,Gastroenterology ,digestive system diseases ,BCLC Stage ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Internal medicine ,Adjunctive treatment ,medicine ,030211 gastroenterology & hepatology ,Liver function ,Stage (cooking) ,Liver cancer ,business ,neoplasms ,medicine.drug - Abstract
Background: Sorafenib is the standard treatment for patients with Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC). However, the treatment outcome is not satisfactory. We retrospectively analyzed whether adding transarterial embolization/chemoembolization (TA(C)E)-based locoregional therapy to sorafenib can further improve treatment efficacy. Patients and Methods: We included 147 BCLC stage C HCC patients with Child-Turcotte-Pugh class A liver function and treated with sorafenib for analysis. Through propensity score matching, we divided patients into the combined treatment group (n = 63; patients received TA(C)E-based locoregional treatment and sorafenib) and the sorafenib monotherapy group (n = 63). We analyzed the effects of patients’ clinical and tumor-related factors on their overall survival (OS) and time to tumor progression. Results: The OS was better in the combined treatment group than in the sorafenib monotherapy group (419 vs. 223 days, p = 0.028). In the Cox regression model, combined treatment, a lower baseline α-fetoprotein (AFP) level < 400 ng/mL, tumors without main portal venous tumorous thrombosis, and age ≥60 years were identified as independent factors for OS. Subgroup analysis demonstrated that patients with a higher baseline AFP level > 400 ng/mL, age < 60 years, tumors with branched portal venous tumorous thrombosis only or without extrahepatic metastasis benefited the most from combined treatment. Conclusion: Combining TA(C)E-based locoregional treatment with sorafenib resulted in better OS in patients with BCLC stage C HCC compared with sorafenib alone. TA(C)E-based locoregional treatment can be an adjunctive treatment to sorafenib for patients with advanced HCC and a satisfactory liver functional reserve.
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- 2018
9. Detection of CTNNB1 Hotspot Mutations in Cell-Free DNA from the Urine of Hepatocellular Carcinoma Patients
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Ying-Hsiu Su, Surbhi Jain, Yih Jyh Lin, Jamin D. Steffen, Wei Song, Sitong Chen, Ting-Tsung Chang, and Selena Y. Lin
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Medicine (General) ,medicine.medical_specialty ,recurrence ,Clinical Biochemistry ,Urine ,medicine.disease_cause ,Gastroenterology ,cell-free DNA ,Exon ,R5-920 ,Internal medicine ,Biopsy ,medicine ,Gene ,Mutation ,medicine.diagnostic_test ,business.industry ,beta-catenin ,hepatocellular carcinoma ,Amplicon ,medicine.disease ,urine ,digestive system diseases ,Cell-free fetal DNA ,Hepatocellular carcinoma ,mutation ,business - Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. The beta-catenin gene, CTNNB1, is among the most frequently mutated in HCC tissues. However, mutational analysis of HCC tumors is hampered by the difficulty of obtaining tissue samples using traditional biopsy. Here, we explored the feasibility of detecting tumor-derived CTNNB1 mutations in cell-free DNA (cfDNA) extracted from the urine of HCC patients. Using a short amplicon qPCR assay targeting HCC mutational hotspot CTNNB1 codons 32–37 (exon 3), we detected CTNNB1 mutations in 25% (18/73) of HCC tissues and 24% (15/62) of pre-operative HCC urine samples in two independent cohorts. Among the CTNNB1-mutation-positive patients with available matched pre- and post-operative urine (n = 13), nine showed apparent elimination (n = 7) or severalfold reduction (n = 2) of the mutation in urine following tumor resection. Four of the seven patients with no detectable mutations in postoperative urine remained recurrence-free within five years after surgery. In contrast, all six patients with mutation-positive in post-operative urine recurred, including the two with reduced mutation levels. This is the first report of association between the presence of CTNNB1 mutations in pre- and post-operative urine cfDNA and HCC recurrence with implications for minimum residual disease detection.
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- 2021
10. Radiotherapy for inferior vena cava tumor thrombus in patients with hepatocellular carcinoma
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Yih Jyh Lin, Wei Ting Hsueh, Wei Lun Chang, Nai Jung Chiang, Yi Sheng Liu, Forn Chia Lin, and Tzu Hui Pao
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Male ,0301 basic medicine ,Cancer Research ,Hepatocellular carcinoma ,medicine.medical_treatment ,0302 clinical medicine ,Surgical oncology ,Neoplasm Metastasis ,Aged, 80 and over ,Venous Thrombosis ,Liver Neoplasms ,Middle Aged ,Prognosis ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Radiation therapy ,Treatment Outcome ,medicine.anatomical_structure ,Oncology ,medicine.vein ,030220 oncology & carcinogenesis ,cardiovascular system ,Female ,Radiology ,Research Article ,Adult ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Combination therapy ,Vena Cava, Inferior ,lcsh:RC254-282 ,Inferior vena cava ,03 medical and health sciences ,Genetics ,medicine ,Humans ,Thrombus ,Aged ,Retrospective Studies ,Inferior vena cava thrombus ,Lung ,business.industry ,medicine.disease ,Survival Analysis ,030104 developmental biology ,Multivariate Analysis ,business ,Follow-Up Studies ,Rare disease - Abstract
Background Hepatocellular carcinoma (HCC) with inferior vena cava (IVC) involvement is a rare disease with poor prognosis. This study aimed to evaluate the outcome of HCC patients receiving radiotherapy (RT) to IVC tumor thrombus. Methods A total of 42 consecutive HCC patients treated with RT to IVC tumor thrombus between September 2007 and October 2018 were enrolled. Overall survival (OS), the response of IVC thrombus, prognostic factors and failure pattern were assessed. Results The median follow-up time was 4.4 months. The median RT equivalent dose in 2-Gy fractions was 48.75 Gy (range, 3.25–67.10). The objective response rate of IVC thrombus was 47.6% (95% confidence interval [CI], 33.3–64.3%). The OS rate at 1 year was 30.0%, with a median OS of 6.6 months (95% CI, 3.7–9.5) from the start of RT. On multivariate analysis, Child-Pugh class, lymph node metastasis, lung metastasis and objective response of IVC thrombus were independent predictors for OS. Lung was the most common site of first progression in 14 (33.3%) patients. For 32 patients without lung metastasis before RT, use of systemic treatment concurrent with and/or after RT was associated with a significantly longer lung metastasis-free survival (5.9 vs. 1.5 months, p = 0.0033). Conclusions RT is effective for IVC tumor thrombus of HCC with acceptable adverse effects. RT might be a treatment option incorporated into combination therapy for HCC involving IVC.
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- 2019
11. Resistance of ground glass hepatocytes to oral antivirals in chronic hepatitis B patients and implication for the development of hepatocellular carcinoma
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Yih Jyh Lin, Hung Wen Tsai, I-Chin Wu, Ih-Jen Su, Pin-Nan Cheng, Ting-Tsung Chang, Chia Jui Yen, Han Chieh Wu, Shih Huang Chan, and Wenya Huang
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Male ,0301 basic medicine ,Pathology ,Necrosis ,Biopsy ,Administration, Oral ,medicine.disease_cause ,Gastroenterology ,0302 clinical medicine ,ground glass hepatocytes ,Medicine ,Sequence Deletion ,medicine.diagnostic_test ,Liver Neoplasms ,Fatty liver ,Lamivudine ,hepatocellular carcinoma ,cccDNA ,Middle Aged ,Viral Load ,Liver ,Oncology ,Hepatocellular carcinoma ,Female ,030211 gastroenterology & hepatology ,DNA, Circular ,medicine.symptom ,Viral load ,Research Paper ,medicine.drug ,Adult ,Hepatitis B virus ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Guanine ,Adolescent ,Organophosphonates ,Antiviral Agents ,Young Adult ,03 medical and health sciences ,Hepatitis B, Chronic ,Internal medicine ,Drug Resistance, Viral ,Humans ,Amino Acid Sequence ,Protein Precursors ,Hepatitis B Surface Antigens ,anti-viral therapy ,business.industry ,Adenine ,medicine.disease ,digestive system diseases ,Fatty Liver ,030104 developmental biology ,Hepatocytes ,pre-S mutation ,business - Abstract
Ground glass hepatocytes (GGHs) have been shown to predict the development of hepatocellular carcinoma (HCC). Type I GGH and type II GGH harbor hepatitis B virus (HBV) pre-S1 and pre-S2 deletion mutants, respectively. Whether anti-HBV therapy can inhibit the expression of GGHs and potentially reduce HCC development is explored in this study. Two sets of liver specimens were included: the first contained 31 paired biopsy specimens obtained from chronic HBV patients receiving oral nucleos(t)ide analogue (NA) treatment; the second contained 186 resected liver tissues obtained from HBV-related HCC patients receiving surgery: 82 received NA before surgery and 104 did not. Compared with the baseline biopsy specimens, type I (P=0.527) and type II GGH (P=0.077) were not significantly decreased after 48 weeks of NA treatment in the first set of patients. In the second set, despite suppression of viral load (P
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- 2016
12. Multidisciplinary Taiwan Consensus Recommendations for the Use of DEBDOX-TACE in Hepatocellular Carcinoma Treatment
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Chun-Chieh Huang, Wei Lun Tsai, Jen I. Hwang, Reng Hong Wu, Ding Kwo Wu, Rheun Chuan Lee, Yi Sheng Liu, Pi Yi Chang, Chih Yung Yu, Po-Chin Liang, Huei Lung Liang, Chien-Hung Chen, Yih Jyh Lin, and Chao-Hung Hung
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medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Consensus Statement ,Guideline ,medicine.disease ,030218 nuclear medicine & medical imaging ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Randomized controlled trial ,law ,Multidisciplinary approach ,Hepatocellular carcinoma ,medicine ,Lipiodol ,030211 gastroenterology & hepatology ,In patient ,Embolization ,Intensive care medicine ,business ,Liver pathology ,medicine.drug - Abstract
Transarterial chemoembolization (TACE) is the first-line treatment in patients with unresectable hepatocellular carcinoma (HCC). In recent years, there has been increasing clinical evidence that drug-eluting beads provide a combined ischemic and cytotoxic effect that may be superior to conventional TACE, with low systemic toxicity. The therapeutic value of TACE performed using the embolic microsphere DC Bead loaded with doxorubicin (drug-eluting bead doxorubicin [DEBDOX]) has been shown by several randomized controlled trials. Since Lencioni et al. [Cardiovasc Intervent Radiol 2012; 35: 980–985] published the first widely accepted technical recommendations on HCC embolization with DEBDOX-TACE in 2012, new studies have contributed to a better understanding of when and how to apply this new therapeutic modality, and they have yet to be incorporated into an updated guideline. Additionally, differences in the underlying liver pathology and practice of transcatheter embolization between Asian and Western populations have not been adequately addressed, and there remain significant variations in the TACE protocols adopted in different parts of the world. These mainly revolve around the number and type of chemotherapeutic agents used, type of embolic material, reliance on Lipiodol, and selectivity of catheter positioning. As a result of these issues, it has been difficult to interpret and compare results obtained from different centers in a systematic fashion. To address these concerns, we convened a panel of experts specializing in different aspects of HCC treatment to craft an updated set of recommendations that better reflect recent clinical experiences and are tailored to the use of DEBDOX-TACE in Taiwan. The conclusions of this expert panel are described in the following article.
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- 2018
13. IL-20 and IL-20R1 antibodies protect against liver fibrosis
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Chi Chen Wei, Ming-Shi Chang, Yu Hsiang Hsu, Yi Shu Chiu, and Yih Jyh Lin
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Liver injury ,medicine.medical_specialty ,Pathology ,Cirrhosis ,Hepatology ,business.industry ,medicine.disease ,Proinflammatory cytokine ,medicine.anatomical_structure ,Fibrosis ,Internal medicine ,Hepatocyte ,medicine ,Hepatic stellate cell ,Cancer research ,GDF15 ,business - Abstract
Interleukin (IL)-20 is a proinflammatory cytokine of the IL-10 family and involved in rheumatoid arthritis, atherosclerosis, stroke, and osteoporosis. However, the pathophysiological roles of IL-20 in liver injury have not been extensively studied. We explored the involvement of IL-20 in liver injury and the therapeutic potential of IL-20 antagonists for treating liver fibrosis. Compared with normal liver tissue from healthy individuals, the amount of IL-20 was much higher in hepatocytes and hepatic stellate cells in liver biopsies from patients with fibrosis, cirrhosis, and hepatocellular carcinoma. Carbon tetrachloride (CCl4) treatment induced IL-20 that further up-regulated the expression of transforming growth factor (TGF)-b1 and p21 WAF1 and resulted in cell cycle arrest in the Clone-9 rat hepatocyte cell line. IL-20 activated quiescent rat hepatic stellate cells (HSCs) and up-regulated TGF-b1 expression. IL-20 also increased TGF-b1, tumor necrosis factor (TNF)-a, and type I collagen (Col-I) expression, and promoted the proliferation and migration of activated HSCs. Serum IL-20 was significantly elevated in mice with short-term and long-term CCl4-induced liver injury. In mice with short-term liver injury, anti-IL-20 monoclonal antibody (7E) and anti-IL-20 receptor (IL-20R1) monoclonal antibody (51D) attenuated hepatocyte damage caused by CCl4, TGF-b1, and chemokine production. In mice with long-term liver injury, 7E and 51D inhibited CCl4-induced cell damage, TGF-b1 production, liver fibrosis, HSC activation, and extracellular matrix accumulation, which was caused by the reduced expression of tissue inhibitors of metalloproteinases as well as increased metalloproteinase expression and Col-I production. IL-20R1-deficient mice were protected from short-term and longterm liver injury. Conclusion: We identified a pivotal role of IL-20 in liver injury and showed that 7E and 51D may be therapeutic for liver fibrosis. (HEPATOLOGY 2014;00:000-000)
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- 2014
14. Cyclooxygenase-2 expression in the tumor environment is associated with poor prognosis in colorectal cancer patients
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Yih Jyh Lin, Chung Ta Lee, Hsiao Sheng Liu, Jenq Chang Lee, and Peng Chan Lin
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Cancer Research ,Pathology ,medicine.medical_specialty ,Oncogene ,Colorectal cancer ,business.industry ,Cell ,Cancer ,colorectal cancer ,Articles ,COX-2 ,Cell cycle ,medicine.disease_cause ,medicine.disease ,Molecular medicine ,tumorigenesis ,medicine.anatomical_structure ,Oncology ,medicine ,Immunohistochemistry ,Carcinogenesis ,business - Abstract
The development of colorectal cancer (CRC) is commonly accompanied by the overexpression of the cyclooxygenase-2 (COX-2) gene, with high levels being most common in early colorectal lesions. In the present study, we hypothesized that the expression of COX-2 in normal mucosa affects the expression of COX-2 in adjacent tumors. COX-2 protein expression levels were determined in tumor tissues and the adjacent normal mucosa of 49 paired clinical CRC specimens using western blotting and immunohistochemistry (IHC) staining. The majority of specimens exhibited an extremely low level of COX-2 expression in the tumor tissue and a markedly higher expression level in the adjacent normal tissue, however, high COX-2 expression in the tumor was shown to correlate with a high recurrence rate and poor overall survival. Of the nine CRC cell lines, HT29 showed consistently higher levels of COX-2 expression. Therefore, COX-2 expression in the normal tissue adjacent to the tumor may be involved in the tumorigenesis of CRC. These observations are likely to be useful in determining the significance of COX-2 expression in the tumorigenesis of CRC.
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- 2013
15. Randomised clinical trial: comparison of two everolimus dosing schedules in patients with advanced hepatocellular carcinoma
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Wu Chou Su, Jin Ding Huang, Pin-Wen Lin, Her-Shyong Shiah, Li-Tzong Chen, Jang Yang Chang, Jacqueline Whang-Peng, Chia-Yen Dai, Yih Jyh Lin, Chin-Fu Hsiao, and Chiung Yu Chen
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Adult ,Liver Cirrhosis ,Male ,Hepatitis B virus ,medicine.medical_specialty ,HBsAg ,Carcinoma, Hepatocellular ,Maximum Tolerated Dose ,medicine.disease_cause ,Gastroenterology ,Young Adult ,Internal medicine ,medicine ,Humans ,Pharmacology (medical) ,Everolimus ,Aged ,Sirolimus ,Hepatitis ,Hepatitis B Surface Antigens ,Dose-Response Relationship, Drug ,Hepatology ,biology ,business.industry ,Liver Neoplasms ,Middle Aged ,Hepatitis B ,medicine.disease ,digestive system diseases ,Surgery ,Alanine transaminase ,Hepatocellular carcinoma ,DNA, Viral ,biology.protein ,Female ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
Summary Background Deregulation of mammalian target of rapamycin (mTOR) signalling is common in human hepatocellular carcinoma (HCC). Aim To determine the maximum tolerated dose (MTD) of the oral mTOR inhibitor everolimus in advanced HCC patients. Methods Patients with locally advanced or metastatic HCC (Child-Pugh class A or B) were enrolled in an open-label phase 1 study and randomly assigned to daily (2.5–10 mg) or weekly (20–70 mg) everolimus in a standard 3 + 3 dose-escalation design. MTD was based on the rate of dose-limiting toxicities (DLTs). Secondary endpoints included safety, pharmacokinetics and tumour response. In a post hoc analysis, serum hepatitis B virus (HBV) DNA levels were quantified. Results Thirty-nine patients were enrolled. DLTs occurred in five of 21 patients in the daily and two of 19 patients in the weekly cohort. Daily and weekly MTDs were 7.5 mg and 70 mg respectively. Grade 3/4 adverse events with a ≥10% incidence were thrombocytopenia, hypophosphataemia and alanine transaminase (ALT) elevation. In four hepatitis B surface antigen (HBsAg)-seropositive patients, grade 3/4 ALT elevations were accompanied by significant (>1 log) increases in serum HBV levels. The incidence of hepatitis flare (defined as ALT increase >100 IU/mL from baseline) in HBsAg-seropositive patients with and without detectable serum HBV DNA before treatment was 46.2% and 7.1% respectively (P
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- 2012
16. Treatment patterns and survival for hepatocellular carcinoma in USA and Taiwan
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Chia-Ni Lin, Sylvia H. Hsu, Yih Jyh Lin, Tannaz Sedghi, Cary P. Gross, Tsung-Ching Chou, Yen-Cheng Chiu, Jung-Der Wang, Shi-Yi Wang, and Hyun Soo Kim
- Subjects
Cancer mortality ,Cancer Research ,medicine.medical_specialty ,High prevalence ,business.industry ,food and beverages ,Hepatitis B ,medicine.disease ,Gastroenterology ,digestive system diseases ,Oncology ,Internal medicine ,Hepatocellular carcinoma ,medicine ,business ,neoplasms - Abstract
e16120Background: Hepatocellular carcinoma (HCC) is the fourth leading cause of cancer mortality in the United States. Due to the high prevalence of hepatitis B/C infection, HCC ranks second in can...
- Published
- 2018
17. Prediction of early hepatocellular carcinoma recurrence using germinal center kinase-like kinase
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Cheng-Hsun Ho, Yih Jyh Lin, Yen-Cheng Chiu, Wen-Chun Liu, Hung Wen Tsai, I-Chin Wu, Hung Yu Sun, Pin-Nan Cheng, Huai-Chia Chuang, Ting-Tsung Chang, Kung Chia Young, and Tse-Hua Tan
- Subjects
0301 basic medicine ,Gerontology ,Oncology ,Male ,Autoimmunity ,Kaplan-Meier Estimate ,Nuclear factor kappa b ,0302 clinical medicine ,Liver tissue ,Cell Cycle ,Liver Neoplasms ,Gene Transfer Techniques ,NF-kappa B ,hepatocellular carcinoma ,Middle Aged ,University hospital ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,Signal Transduction ,Research Paper ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,recurrence ,Genetic Vectors ,Protein Serine-Threonine Kinases ,Resection ,03 medical and health sciences ,Internal medicine ,Protein Kinase C beta ,medicine ,Early Hepatocellular Carcinoma ,Humans ,Aged ,Cell Proliferation ,Proportional Hazards Models ,Retrospective Studies ,National health ,business.industry ,Lentivirus ,Germinal center ,medicine.disease ,digestive system diseases ,030104 developmental biology ,Hepatocytes ,GLK ,Neoplasm Recurrence, Local ,business ,NFκB - Abstract
// Cheng-Hsun Ho 1, 2, * , Huai-Chia Chuang 3, * , I-Chin Wu 2 , Hung-Wen Tsai 4, 5 , Yih-Jyh Lin 6 , Hung-Yu Sun 7 , Kung-Chia Young 7 , Yen-Cheng Chiu 2 , Pin-Nan Cheng 2 , Wen-Chun Liu 2, 5 , Tse-Hua Tan 3, 8 , Ting-Tsung Chang 2, 5, 9 1 Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 2 Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 3 Immunology Research Center, National Health Research Institutes, Zhunan, Taiwan 4 Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 5 Infectious Disease and Signaling Research Center, National Cheng Kung University, Tainan, Taiwan 6 Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan 7 Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan 8 Department of Pathology & Immunology, Baylor College of Medicine, Houston, Texas, USA 9 Institute of Molecular Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan * These authors have contributed equally to this work Correspondence to: Ting-Tsung Chang, email: ttchang@mail.ncku.edu.tw Tse-Hua Tan, email: ttan@nhri.org.tw Keywords: hepatocellular carcinoma, recurrence, GLK, NFκB Received: September 08, 2015 Accepted: June 04, 2016 Published: June 20, 2016 ABSTRACT Germinal center kinase-like kinase (GLK) is a key controller of autoimmunity. In this study, we assessed the clinical relevance and tumorigenic effects of GLK in hepatocellular carcinoma (HCC). Using immunohistochemistry, we showed that the GLK proportion score increased in both cancerous and adjacent non-cancerous liver tissue from patients with HCC recurrence. A Kaplan-Meier analysis revealed that patients with a wide distribution of GLK in non-cancerous liver tissue had a higher rate of HCC recurrence than those with very low or no GLK expression. Multivariate Cox regression analyses indicated that a high GLK proportion score in non-cancerous liver tissue was an independent predictor of early HCC recurrence after resection. Lentiviral vector-mediated overexpression of GLK activated the nuclear factor kappa B (NFκB) signaling cascade and accelerated cell cycle progression in primary human hepatocytes, thereby promoting proliferation. An increase in GLK expression coincided with NFκB activation and enhanced expression of proliferating cell nuclear antigen in HCC tissue. Our findings demonstrate a potential hepatocarcinogenic effect of GLK and the feasibility of using GLK to predict early HCC recurrence.
- Published
- 2015
18. Co-expression of RON and MET is a prognostic indicator for patients with transitional-cell carcinoma of the bladder
- Author
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Tzong Shin Tzai, Nan Haw Chow, Chung Liang Ho, Helen H.W. Chen, Hsiao Sheng Liu, T. Y. Chang, Yih Jyh Lin, P. Y. Hsu, and H. L. Cheng
- Subjects
Cancer Research ,Pathology ,medicine.medical_specialty ,Polymerase Chain Reaction ,Proto-Oncogene Mas ,Receptor tyrosine kinase ,Cohort Studies ,Biomarkers, Tumor ,medicine ,Humans ,Lung cancer ,Molecular Diagnostics ,Carcinoma, Transitional Cell ,Bladder cancer ,Oncogene ,biology ,Hepatocyte Growth Factor ,business.industry ,Gene Expression Profiling ,Macrophages ,MST1R ,Receptor Protein-Tyrosine Kinases ,Cancer ,protein tyrosine kinases ,Proto-Oncogene Proteins c-met ,RON ,Prognosis ,medicine.disease ,Immunohistochemistry ,Survival Analysis ,co-expression ,Transitional cell carcinoma ,Urinary Bladder Neoplasms ,Oncology ,Cancer cell ,MET ,Cancer research ,biology.protein ,bladder cancer ,business - Abstract
Recepteur d'Origine Nantais (RON) is a distinct receptor tyrosine kinase in the c-met proto-oncogene family. We examined the mutational and expression patterns of RON in eight human uroepithelial cell lines. Biological effects of RON overexpression on cancer cells were investigated in vitro, and the prognostic significance of RON and/or c-met protein (MET) expression was analysed in a bladder cancer cohort (n=183). There was no evidence of mutation in the kinase domain of RON. Overexpression of RON using an inducible Tet-off system induced increased cell proliferation, motility, and antiapoptosis. Immunohistochemical analysis showed that RON was overexpressed in 60 cases (32.8%) of primary tumours, with 14 (23.3%) showing a high level of expression. Recepteur d'Origine Nantais expression was positively associated with histological grading, larger size, nonpapillary contour, and tumour stage (all P
- Published
- 2005
19. Induction of Antinociception and Increased Met-Enkephalin Plasma Levels by Cyclosporine and Morphine in Rats: Implications of the Combined Use of Cyclosporine and Morphine and Acute Posttransplant Neuropsychosis
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Po-Chang Lee, Chung-Jye Hung, Jih Ing Chuang, Kuei Sen Hsu, Huan Yao Lei, Yih Jyh Lin, and Yu Chuan Tsai
- Subjects
Male ,Met-enkephalin ,medicine.medical_specialty ,Enkephalin, Methionine ,Analgesic ,Peptide hormone ,Rats, Sprague-Dawley ,chemistry.chemical_compound ,Postoperative Complications ,Internal medicine ,medicine ,Animals ,Opioid peptide ,Pain, Postoperative ,Transplantation ,Morphine ,business.industry ,Mental Disorders ,beta-Endorphin ,Nociceptors ,Rats ,Analgesics, Opioid ,Endocrinology ,Nociception ,chemistry ,Cyclosporine ,Surgery ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
Background. Cyclosporine A (CsA) and morphine have neurotoxic and psychiatric side effects, respectively. Endogenous opiatelike peptides can elicit a number of behavioral responses that mimic the symptoms of psychiatric illness. The purpose of this study was to quantitiate the changes of Met-enkephalin (ME) and β-endorphin (BE) after administration of CsA and morphine in surgery and to assess the antinociceptive effect. Patients and materials. Pain sensitivity, an antinociceptive indicator in rats, was determined with the hotplate test. Plasma ME and BE levels were measured with radioimmunoassays. Results. In normal unoperated rats, CsA induced a profound analgesic effect concomitant with an increased plasma ME level on day 1. Morphine produced an analgesic effect on days 1 and 2, with decreased ME levels on days 2 and 3. Coadministration of CsA and morphine prolonged the analgesia from days 1 to 4 and increased the plasma ME level on day 1. No change in plasma BE level was found. In surgically operated rats, CsA induced an analgesic effect and higher ME levels than those in unoperated rats. Interestingly, the combined use of CsA and morphine prolonged the analgesia and increased plasma ME levels from days 1 to 4, with no significant change in plasma BE levels. Conclusions. Our results showed that CsA can induce antinociception and increase plasma ME levels. This induction can be potentiated by the addition of morphine. Acute neuropsychiatric manifestations in the early posttransplant period might, therefore, be due to induction of ME after coadministration of CsA and morphine.
- Published
- 2002
20. Five-Year Experience of Adoption and Evolution of Laparoscopic Living Donor Nephrectomy: Results From a Center Without Large Volume of Patients
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Jen-Pin Chuang, Tsung-Ching Chou, Yih Jyh Lin, P. Y. Chung, Y. S. Lin, Chung-Jye Hung, Shen-Shin Chang, and Po-Chang Lee
- Subjects
Adult ,Male ,medicine.medical_specialty ,Intraoperative Complication ,Urinary system ,medicine.medical_treatment ,Taiwan ,Renal function ,Nephrectomy ,Body Mass Index ,Living Donors ,medicine ,Humans ,Aged ,Retrospective Studies ,Transplantation ,business.industry ,Postoperative complication ,Perioperative ,Middle Aged ,Kidney Transplantation ,Surgery ,Treatment Outcome ,Creatinine ,Female ,Laparoscopy ,Complication ,business - Abstract
Objectives Despite the advantages of laparoscopic living donor nephrectomy (LDN), this technique is known to have a steep learning curve that makes worldwide adoption challenging, especially in institutions without a large patients volume. Herein, we have reviewed our 5-year experience of adoption and evolution of this surgical technique, examining the donor and recipient outcomes. Methods Between September 2002 and June 2007, 40 LDNs were performed consecutively. Our surgical technique was mainly derived from the University of California San Francisco method. We retrospectively reviewed the donor demographics, operative characteristics, perioperative complication of donors/recipients, and outcomes of donors and recipients. Results Among the 40 cases, 36 (90.0%) were left-sided LDNs. Mean operative time was 335.1 ± 66.9 minutes, blood loss was 303.9 ± 333.2 mL, and warm ischemia time was 243.2 ± 127.0 seconds. Multiple renal arteries required bench arterial reconstruction in 7 (17.5%) donor kidneys. Three renovascular injuries occurred intraoperatively, and 2 (5.0%) required open conversion. The overall postoperative complication rate was 20.0%. Postoperative donor serum creatinine was 1.5 times higher than preoperative serum creatinine. All but one recipient was discharged with adequate renal function. Graft function continues in 36 of the 38 harvested kidneys (94.7%) during the follow-up period. One (2.5%) recipient developed ureteral necrosis, and no recipients developed vascular thrombosis. Conclusions LDNs can be performed with careful adoption and evolution in institutions without a large patient volume. The intraoperative complication rate of LDN can be reduced with experience.
- Published
- 2008
21. Lin28B is an oncofetal circulating cancer stem cell-like marker associated with recurrence of hepatocellular carcinoma
- Author
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Pin-Nan Cheng, Hung Wen Tsai, Hsuan Pang Huang, Chia Jui Yen, Chung Ta Lee, Shih Huang Chan, Shu Wen Cheng, Yih Jyh Lin, Nan Haw Chow, Ting-Tsung Chang, Yun Pei Chuang, Yu-Chung Chang, Chung Liang Ho, An-Ning Chao, and Cheng Yang Chou
- Subjects
Adult ,Male ,Pathology ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,lcsh:Medicine ,Biology ,LIN28 ,Circulating tumor cell ,SOX2 ,Cancer stem cell ,medicine ,Carcinoma ,Biomarkers, Tumor ,Hepatectomy ,Humans ,RNA, Messenger ,lcsh:Science ,Aged ,Neoplasm Staging ,Homeodomain Proteins ,Multidisciplinary ,SOXB1 Transcription Factors ,lcsh:R ,Liver Neoplasms ,Cancer ,RNA-Binding Proteins ,Hep G2 Cells ,Nanog Homeobox Protein ,Middle Aged ,medicine.disease ,Neoplastic Cells, Circulating ,Survival Analysis ,Gene Expression Regulation, Neoplastic ,Hepatocellular carcinoma ,Cancer cell ,Cancer research ,Neoplastic Stem Cells ,lcsh:Q ,Female ,Neoplasm Recurrence, Local ,Octamer Transcription Factor-3 ,Research Article - Abstract
By using an expressed sequence tag bioinformatic algorithm, we identified that Lin28 homolog B (Lin28B) may have an oncofetal expression pattern which may facilitate detecting cancer cells in adults. It is also reported to be a potential marker for cancer stem cells. Therefore, we sought to verify oncofetal-stemness characters of Lin28B and test its potential as a circulating cancer stem cell-like marker in adult HCC patients. Lin28B mRNA was examined in a panel of fetal tissue, adult tissue and tumors. Lin28B was over-expressed or knocked down in HepG2 cells to evaluate its potential as a stem cell-like marker. RT-qPCR for Lin28B was performed in the peripheral blood mononuclear cells from patients with HCC receiving surgery (n=96) and non-HCC controls (n=60) and analyzed its clinical significance. Lin28B showed an oncofetal expression pattern. Its overexpression could upregulate stemness markers (OCT4, Nanog and SOX2) and enhance tumorsphere formation in vitro. Lin28B knockdown had opposite effects. Circulating Lin28B was detected in peripheral blood mononuclear cells in 3 cases (5%) of non-HCC controls and 32 cases (33.3%) of HCC patients. In HCC patients, circulating Lin28B was associated with high tumor grade (P=0.046), large size (P=0.005), high AJCC stage (P=0.044) and BCLC stage (P=0.017). Circulating Lin28B was significantly associated with decreased recurrence-free survival (P
- Published
- 2013
22. Association between preoperative allograft function (effective renal plasma flow) and the change in glomerular filtration rate among living-donor kidney transplant recipients
- Author
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Po-Chang Lee, P. Y. Chung, Chung-Jye Hung, Yih Jyh Lin, Shen-Shun Chang, Y. S. Lin, and Tsung-Ching Chou
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Time Factors ,Urology ,Taiwan ,Renal function ,urologic and male genital diseases ,Living donor ,Kidney transplant ,Risk Assessment ,Risk Factors ,Linear regression ,medicine ,Retrospective analysis ,Living Donors ,Humans ,Transplantation, Homologous ,Intensive care medicine ,Retrospective Studies ,Transplantation ,urogenital system ,business.industry ,Age Factors ,Effective renal plasma flow ,Middle Aged ,Kidney Transplantation ,Renal Plasma Flow, Effective ,Treatment Outcome ,Multivariate Analysis ,Linear Models ,Surgery ,Female ,Kidney Diseases ,business ,Glomerular Filtration Rate - Abstract
Background Predonation kidney function may be an important factor affecting graft outcome. Increased baseline allograft function may be more effective than strategies to slow the decline in glomerular filtration rate (GFR). However, the role of donor effective renal plasma flow (ERPF) on long-term outcome is less well understood. The purpose of this study was to examine the relationship between preoperative allograft function as measured by ERPF and the decline of allograft function as defined by the annualized change in GFR among living-donor kidney transplant recipients. Methods We performed a retrospective analysis of 83 patients who underwent living donor renal transplantation at our institution from March 2001 to October 2010. A time series analysis of autoregressive integrated moving average (ARIMA) model was applied to determine the annualized change in GFR after transplantation. Univariate and stepwise multivariate analyses were performed using linear regression between preoperative ERPF and annualized change in GFR after transplantation. We also investigated the influence on annualized change in GFR of other donor or recipient variables. Results The ARIMA model revealed that the annualized change in GFR was −1.344 ± 12.476 mL/min/1.73 m 2 per year. Pearson correlation coefficient for the association between predonation ERPF of the transplanted kidney and the annualized change in GFR was 0.033 ( P = .777). Conclusions Poor predonation kidney function was not associated with an increased rate of decline of allograft function. Neither donor age nor renal function (preoperative ERPF value) was a valid predictor of change in GFR among living-donor kidney transplant recipients.
- Published
- 2012
23. Cyclosporine or tacrolimus: which is the better partner for myfortic or cellcept?
- Author
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Chung-Jye Hung, Ren-Hao Chan, Yih Jyh Lin, S. C. Shieh, Z. C. Wu, Shen-Shun Chang, Tsung-Ching Chou, Jung-Der Wang, W. M. Wang, and Po-Chang Lee
- Subjects
Graft Rejection ,medicine.medical_specialty ,medicine.medical_treatment ,Taiwan ,Pharmacology ,Mycophenolate ,Gastroenterology ,Mycophenolic acid ,Tacrolimus ,Pharmacotherapy ,Pharmacokinetics ,HLA Antigens ,Isoantibodies ,Internal medicine ,medicine ,Humans ,Drug Interactions ,Retrospective Studies ,Transplantation ,business.industry ,Graft Survival ,Mycophenolate Sodium ,Immunosuppression ,Mycophenolic Acid ,Kidney Transplantation ,Treatment Outcome ,Concomitant ,Histocompatibility ,Cyclosporine ,Surgery ,Drug Therapy, Combination ,Drug Monitoring ,business ,Immunosuppressive Agents ,medicine.drug - Abstract
Background Mycophenolic acid (MPA) pharmacokinetics using the mycophenolate mofetil (CellCept) formulation are known to differ between patients receiving tacrolimus (FK) or cyclosporine (CyA), but only limited data exist concerning concomitant use of FK or CyA with enteric-coated mycophenolate sodium (EC-MPS; Myfortic). This retrospective study compared the drug interactions with the mycophenolic acid blood levels using different immunosuppressants and their relation to graft survival. Patients and methods We studied MPA levels in posttransplant sera from 298 renal transplant recipients. Results Patients receiving immunosuppression with CyA + Myfortic showed 94% at 5- and 10-year graft survivals, which were better than CyA + CellCept (75%, 63%). This combination suppressed posttransplant human leukocyte antigen (HLA) antibody development significantly ( P = .03) with higher MPA levels. Conclusion Patients immunosuppressed with CyA + Myfortic showed higher MPA levels and lower posttransplant HLA antibody development as well as the best graft survival. CyA + Myfortic or FK + Cellcept may be better combinations.
- Published
- 2012
24. Dynamic change of tetraspanin CD151 membrane protein expression in colorectal cancer patients
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Jenq Chang Lee, Peng Chan Lin, Shao Chieh Lin, Yih Jyh Lin, and Chung Ta Lee
- Subjects
Oncology ,Adenoma ,Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Colorectal cancer ,Tetraspanin 24 ,Disease-Free Survival ,Metastasis ,Tetraspanin ,Antigen ,Antigens, CD ,Internal medicine ,medicine ,Humans ,Stage (cooking) ,CD151 ,Aged ,Neoplasm Staging ,Aged, 80 and over ,business.industry ,Liver Neoplasms ,General Medicine ,Hypoxia (medical) ,Middle Aged ,medicine.disease ,digestive system diseases ,Membrane protein ,Cancer research ,Female ,medicine.symptom ,business ,Colorectal Neoplasms - Abstract
Purpose: To measure the CD151 expression in colorectal cancer (CRC). Methods: CD151 expression was assessed in 179 CRC patients and 39 patients with hepatic liver metastasis. Results: High CD151 expression was observed in 48% of patients with early-stage CRC versus only 33% of patients with metastatic colon cancer. A higher level of tumor invasion status correlated with a decrease in CD151 expression. Metastatic stage and advanced tumor stage correlated with a decreased CD151 expression. Twenty-seven out of the 39-paired samples had high CD151 expression in liver metastasis sites. Conclusions: CD151 expression is decreased in patients with metastatic CRC.
- Published
- 2011
25. Outcomes in Elder Heart Transplantation Recipients: An Analysis of Taiwan Organ Registry and Sharing Center Registry
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P. Hsu, Chih-Che Lin, Wei-Chen Lee, Chi-Neu Tsai, Y. Tsai, C. Lai, K. Lee, Yih Jyh Lin, Chii-Ming Lee, and Feng-Huei Lin
- Subjects
Heart transplantation ,Transplantation ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Emergency medicine ,medicine ,Center (algebra and category theory) ,business - Published
- 2014
26. A clustered ground-glass hepatocyte pattern represents a new prognostic marker for the recurrence of hepatocellular carcinoma after surgery
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Wenya Huang, Shih Huang Chan, Yih Jyh Lin, Hung Wen Tsai, Pin Wen Lin, Kai Hsi Hsu, Chia Jui Yen, Ih-Jen Su, and Han Chieh Wu
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,HBsAg ,Hepatitis B virus ,Carcinoma, Hepatocellular ,Genotype ,medicine.medical_treatment ,Ground glass hepatocyte ,medicine.disease_cause ,Polymerase Chain Reaction ,medicine ,Carcinoma ,Biomarkers, Tumor ,Hepatectomy ,Humans ,Aged ,Sequence Deletion ,Hepatitis B Surface Antigens ,business.industry ,Liver Neoplasms ,Cancer ,Middle Aged ,Viral Load ,medicine.disease ,Prognosis ,digestive system diseases ,Surgery ,Oncology ,Hepatocellular carcinoma ,Hepatocytes ,Female ,Neoplasm Recurrence, Local ,business ,Viral load ,Precancerous Conditions - Abstract
BACKGROUND: The recurrence of hepatocellular carcinoma (HCC) after hepatectomy is a serious event. It has been demonstrated that different ground-glass hepatocyte (GGH) patterns harbor specific hepatitis B virus (HBV) pre-S deletion mutants and represent preneoplastic lesions in chronic HBV infection. In the current study, the authors investigated whether a specific GGH pattern in nontumorous liver tissues was associated with the recurrence of HBV-related HCC after surgery. METHODS: Clinicopathologic data from 82 patients with HBV-related HCC were reviewed. GGH patterns were assessed on hematoxylin and eosin-stained sections. Tissue hepatitis B surface antigen (HBsAg) expression was evaluated by immunohistochemical staining. Serum profiles of pre-S status, viral load, and HBV genotype were determined and correlated with clinical recurrence and survival after surgery. RESULTS: The results indicated that the clustered pattern of GGHs or HBsAg expression was associated significantly with decreased local recurrence-free survival (LRFS) during a mean follow-up of 46.4 months (P
- Published
- 2010
27. Influence of preoperative allograft function (effective renal plasma flow) on the short-term outcome following living donor kidney transplantation
- Author
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P. Y. Chung, Shen-Shin Chang, Tsung-Ching Chou, Jen-Pin Chuang, Chung-Jye Hung, Po-Chang Lee, Yih Jyh Lin, and Y. S. Lin
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Urology ,Renal function ,Preoperative care ,Nephrectomy ,Renal Circulation ,Preoperative Care ,medicine ,Living Donors ,Humans ,Transplantation, Homologous ,Kidney transplantation ,Retrospective Studies ,Body surface area ,Transplantation ,Kidney ,business.industry ,Effective renal plasma flow ,medicine.disease ,Kidney Transplantation ,Surgery ,medicine.anatomical_structure ,Treatment Outcome ,Tissue and Organ Harvesting ,Laparoscopy ,business ,Glomerular Filtration Rate - Abstract
Objectives Predonation kidney function is supposed to be an important factor affecting graft outcome. Controversial evidence suggests that higher predonation glomerular filtration rate (GFR) positively correlated with posttransplant graft outcome. The purpose of this study was to examine the relationship between living donor graft kidney function as measured by effective renal plasma flow (ERPF) and short-term graft function. Methods We performed a retrospective analysis of 45 patients who underwent living donor renal transplantation at our institution from 2001 to 2007. The comprehensive nuclear medicine evaluation of donors' ERPF was performed before laparoscopic nephrectomy. The preoperative absolute ERPF–recipient body surface area (F/BSA) ratio and absolute ERPF–recipient body weight (F/Wt) ratio were determined for each donor–recipient pair. Posttransplant graft function was estimated by the four-variable Modification of Diet in Renal Disease (Chinese MDRD) equation. Results Estimated GFR correlated with F/BSA ratio at 3 months and 6 months (Pearson r = .495, P = .001 and r = .441, P = .012). Estimated GFR correlated with F/Wt ratio at 3 months and 6 months ( r = .567, P r = .453, P = .009). The correlations between the estimated GFR at 3 months and other variables were investigated. However, in the final multivariate model, F/BSA ratio and F/Wt ratio were the independent predictors of graft function. Conclusion Preoperative ERPF can be used to calculate F/BSA and F/Wt ratios before living donor kidney transplantation. Our study provided evidence that F/BSA and F/Wt ratios may be considered predictive indices for short-term outcomes. An extreme discrepancy should be avoided between preoperative allograft function (absolute ERPF) and recipient body surface area or body weight.
- Published
- 2008
28. Eighteen-year follow-up of a retrospective study of HLA antibody on kidney graft survival
- Author
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Po-Chang Lee, M. Ozawa, Tsung-Ching Chou, Yih Jyh Lin, Chung-Jye Hung, and Shen-Shin Chang
- Subjects
medicine.medical_specialty ,Time Factors ,Enzyme-Linked Immunosorbent Assay ,Human leukocyte antigen ,Gastroenterology ,Antigen ,HLA Antigens ,Isoantibodies ,Internal medicine ,medicine ,Humans ,In patient ,Hla antibodies ,Survivors ,Retrospective Studies ,Transplantation ,Kidney ,biology ,business.industry ,Graft Survival ,Retrospective cohort study ,Kidney Transplantation ,Survival Analysis ,surgical procedures, operative ,medicine.anatomical_structure ,Immunology ,biology.protein ,Surgery ,Graft survival ,Antibody ,business ,Follow-Up Studies - Abstract
An increasing number of studies have demonstrated adverse graft survival in patients who have anti-HLA antibodies, whether preformed or developed posttransplantation. This retrospective study used Lambda antigen tray-mixed (LAT-M) screening and Luminex HLA class I and II specificity assay to re-examine the impact of pretransplantation HLA antibody on long-term graft survival. In this study, pretransplantation sera from 288 renal patients were tested using the enzyme-linked immunosorbent assay (ELISA) method, LAT-M. Among the 234 of the patients who did not have pretransplantation antibodies, 85% enjoyed 5-year functional graft survival, 76% 10-year functional graft survival, and 56% 15-year functional graft survival. The corresponding functional graft survival for the 54 patients who tested HLA antibody-positive was 65%, 53%, and 28%, respectively (P = .0021).
- Published
- 2008
29. Safe induction of diabetes by high-dose streptozotocin in pigs
- Author
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Hidetaka, Hara, Yih Jyh, Lin, Xiaocheng, Zhu, Hao-Chih, Tai, Mohamed, Ezzelarab, A N, Balamurugan, A N, Balamarugan, Rita, Bottino, Stuart L, Houser, and David K C, Cooper
- Subjects
Blood Glucose ,medicine.medical_specialty ,endocrine system diseases ,Swine ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Body weight ,Streptozocin ,Diabetes Mellitus, Experimental ,Endocrinology ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,Medicine ,Animals ,Humans ,Insulin ,Pancreas ,Glucose tolerance test ,Hepatology ,Insulin blood ,medicine.diagnostic_test ,C-Peptide ,business.industry ,Body Weight ,nutritional and metabolic diseases ,Fasting ,Glucose Tolerance Test ,medicine.disease ,Streptozotocin ,humanities ,Pancreatectomy ,Experimental pathology ,Female ,business ,medicine.drug - Abstract
Streptozotocin (STZ) has been widely used to induce diabetes in rodents and nonhuman primates, but it has been found difficult to achieve a completely diabetic state in pigs in the absence of detrimental side effects. As a result, pancreatectomy has been advocated in this species. We have investigated the effects of 2 dosages of STZ to safely induce diabetes in pigs.Three pigs received Zanosar STZ at 150 mg/kg (group 1). Four pigs received Zanosar STZ at 200 mg/kg (group 2). The levels of glucose, insulin, and C-peptide when (a) fasting, (b) 30 minutes after eating, and (c) during intravenous glucose tolerance tests (IVGTTs) were measured in all pigs for 4 weeks after STZ injection. To confirm how long the diabetic state can be maintained after induction with STZ, levels were measured for 20 weeks in group 2.One to 4 weeks after STZ administration, in group 1 (150 mg/kg) pigs, insulin and C-peptide levels were detected up to 7 microIU/mL and 0.4 ng/mL, respectively, both when fasting and after a meal test or IVGTT, indicating that the pigs had failed to become fully diabetic. In group 2 (200 mg/kg) pigs, insulin and C-peptide levels were less than the 2 microIU/mL and 0.25 ng/mL respective detection levels and did not increase after a meal test or IVGTT. Group 2 remained completely diabetic for the entire 20-week period of follow-up, without STZ-related hepatic or renal dysfunction.High-dose (200 mg/kg) Zanosar STZ induces diabetes safely and completely in pigs without side effects. Pancreatectomy can, therefore, be avoided.
- Published
- 2008
30. The pig-to-primate immune response: relevance for xenotransplantation
- Author
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Hao-Chih Tai, David Ayares, Cassandra Long, David K. C. Cooper, Xiaocheng Zhu, Yih Jyh Lin, Mohamed Ezzelarab, Hidetaka Hara, and Suyapa Ball
- Subjects
medicine.medical_specialty ,Swine ,Xenotransplantation ,medicine.medical_treatment ,Immunology ,Transplantation, Heterologous ,Graft vs Host Disease ,Biology ,Peripheral blood mononuclear cell ,Organ transplantation ,Animals, Genetically Modified ,Immune system ,medicine ,Cytotoxic T cell ,Animals ,Humans ,Transplantation ,Mixed lymphocyte reaction ,Cytotoxicity Tests, Immunologic ,Galactosyltransferases ,Papio anubis ,Immunoglobulin G ,biology.protein ,Antibody ,Lymphocyte Culture Test, Mixed ,Allotransplantation - Abstract
Background: The allotransplantation of some solid organs can be associated with a graft-vs.-host (GVH) response from the activity of donor B or T cells. We have investigated whether there is a risk of a GVH response following pig-to-primate organ xenotransplantation. Methods: The responses of 16 pigs (six farm-housed wild-type and five wild-type housed under high herd health conditions [all designated WT], and 5 α1,3-galactosyltransferase gene-knockout [GT-KO] housed under high herd health conditions) to human (n = 6) and baboon (n = 6) peripheral blood mononuclear cells (PBMC) were determined. Assays included flow cytometry, complement-dependent cytotoxicity, and mixed lymphocyte reaction. Results: Anti-primate cytotoxic IgM antibodies were detected in the sera of all pigs, but anti-primate IgG antibodies were minimal. All pigs demonstrated a cellular proliferative response to primate PBMC that was equivalent to, or greater than, the allo response. The strength of the pig-to-primate GVH responses was proportional to the health status of the pigs, those from a high health status herd, particularly from a specific pathogen-free herd maintained under clean husbandry conditions, where colonization of the gastrointestinal tract may be reduced, having lower responses. Conclusions: After pig organ transplantation in a primate, if the organ is from an early-weaned, early-segregated GT-KO pig, the strength of a GVH response is likely to be relatively weak. Although not investigated here, any GVH response is likely to be suppressed by the immunosuppressive therapy administered to the recipient to suppress the anti-donor immune response.
- Published
- 2007
31. A review of obturator hernia and a proposed algorithm for its diagnosis and treatment
- Author
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Shen Shin Chang, Yan Shen Shan, Pin Wen Lin, Yih Jyh Lin, and Yun Sheng Tai
- Subjects
medicine.medical_specialty ,Fatal Outcome ,Medicine ,Humans ,Hernia ,Obturator hernia ,Laparoscopy ,Aged ,Retrospective Studies ,Aged, 80 and over ,medicine.diagnostic_test ,business.industry ,Hernia, Obturator ,Obturator canal ,Retrospective cohort study ,Vascular surgery ,Pectineus muscle ,Middle Aged ,medicine.disease ,Surgery ,Treatment Outcome ,Female ,business ,Tomography, X-Ray Computed ,Algorithms ,Abdominal surgery - Abstract
The aim of this article is to provide a review of six patients with the various stages of obturator hernia and a diagnostic and therapeutic strategy in suspected cases. Obturator hernia is relatively rare and is a diagnostic challenge. It is a significant cause of intestinal obstruction, especially in emaciated elderly women with chronic disease. A palpable groin mass is not common in these patients because the hernia mass is usually concealed beneath the pectineus muscle. The high mortality is directly related to the delayed recognition, with resultant ruptured gangrenous bowel, and to the high incidence of patients with concurrent medical illness. A total of six patients with obturator hernias were treated at this hospital between 1994 and 2004, and one of these patients was diagnosed and treated by elective laparoscopy. We reviewed these six cases and examined the clinical presentation, age, body weight, associated medical conditions, preoperative diagnosis, operative findings, complications, and outcome in this retrospective study. We concluded that we cannot shorten the time from onset of symptoms to admission, but what we can do is to make a rapid evaluation and surgical intervention to reduce the morbidity and mortality from obturator hernia. The approaches to different presentation of obturator hernia and diagnostic role of CT scan are also discussed.
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- 2005
32. MULTICENTRIC RETROPERITONEAL LEIOMYOSARCOMA WITH SATELLITE LESIONS NOT FOUND ON PET-CT: A CASE REPORT AND LITERATURE REVIEW
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Yih Jyh Lin, Chin Chiang Hsieh, Kuo-Yuan Huang, and Rong-Sen Yang
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Leiomyosarcoma ,Retroperitoneal Leiomyosarcoma ,PET-CT ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Descending colon ,body regions ,medicine.anatomical_structure ,Ureter ,Positron emission tomography ,Medicine ,Abdomen ,Orthopedics and Sports Medicine ,Radiology ,business - Abstract
Most retroperitoneal leiomyosarcomas are clinically silent and are usually detected late, so a large size main tumor accompanied by satellite lesions might be presented. We report a case of a large multicentric retroperitoneal leiomyosarcoma with satellite lesions in the left iliac region, mimicking an abscess, was found on pre-operative pelvic computed tomography (CT). Positron emission tomography (PET-CT) was performed, but revealed only focal bony destruction of the left ilium and no discernable lesions in the abdomen. After resection of the iliacus satellite lesion, CT and magnetic resonance imaging (MRI) of the abdomen revealed another huge retroperitoneal leiomyosarcoma with invasion of the left kidney and ureter, descending colon and left iliac arteries. The patient was then treated with a multidisciplinary extensive excision operation. The clinical presentation, operative findings and imaging findings were reported and related articles were reviewed.
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- 2014
33. Adjuvant heparanase inhibitor PI-88 therapy for hepatocellular carcinoma recurrence
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Stanley Shi Chung Chang, Cheng Chung Wu, Ming-Chih Ho, Mei Due Yang, Juliana Chang, Deng Yn Lin, Rey-Heng Hu, Wei-Chen Lee, King Tong Mok, Kuan Lang Lai, Yih Jyh Lin, Cheng Yuan Peng, Long Bin Jeng, Chun-Jen Liu, Po-Huang Lee, Pei-Jer Chen, Sheng-Shun Yang, Hong-Zen Yeh, and Ming-Chin Yu
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Adult ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Time Factors ,medicine.medical_treatment ,Taiwan ,Observational Study ,Oligosaccharides ,Phases of clinical research ,Antineoplastic Agents ,Gastroenterology ,Disease-Free Survival ,Drug Administration Schedule ,Risk Factors ,Internal medicine ,medicine ,Adjuvant therapy ,Humans ,Heparanase ,Enzyme Inhibitors ,Survival analysis ,Aged ,Glucuronidase ,business.industry ,Liver Neoplasms ,General Medicine ,Middle Aged ,Hepatitis B ,medicine.disease ,Heparanase inhibitor PI-88 ,Survival Analysis ,digestive system diseases ,Treatment Outcome ,Chemotherapy, Adjuvant ,Hepatocellular carcinoma ,Female ,business ,Adjuvant - Abstract
AIM: To demonstrate that administering heparanase inhibitor PI-88 at 160 mg/d is safe and promising in reducing hepatocellular carcinoma (HCC) recurrence for up to 3 year following curative resection. METHODS: A total of 143 patients (83.1% of the 172 participants in the phase II study) participated in the follow-up study. Of these patients, 50 had received no treatment, 48 had received 160 mg/d PI-88, and 45 had received 250 mg/d PI-88 during the phase II trial. Safety parameters and the following efficacy endpoints were investigated: (1) time to recurrence; (2) disease-free survival; and (3) overall survival. RESULTS: PI-88 at 160 mg/d delayed the onset and frequency of HCC recurrence, and provided a clinically significant survival advantage for up to 3 years after treatment compared with those of the control group: (1) the recurrence-free rate increased from 50% to 63%, and (2) time to recurrence at the 36th percentile was postponed by 78%. The efficacy of administering PI-88 at 250 mg/d was confounded by a high dropout rate (11 out of 54 patients). Additionally, subgroup analyses of patients with (1) multiple tumors or a single tumor ≥ 2 cm; and (2) hepatitis B or C revealed that administering PI-88 at 160 mg/d conferred the most significant survival advantage (56.8% improvement in disease-free survival, P = 0.045) for patients with both risk factors for recurrence. CONCLUSION: Administering PI-88 at 160 mg/d is a safe and well-tolerated dosage that may confer significant clinical benefits for patients with HCC.
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- 2014
34. Polycystic kidney patient as a cadaveric donor: is it appropriate?
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Chung-Jye Hung, Yih Jyh Lin, Edgar D. Sy, Yan Shen Shan, and Po-Chang Lee
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Adult ,Male ,Transplantation ,Kidney ,medicine.medical_specialty ,business.industry ,Cadaveric donor ,Renal function ,medicine.disease ,Polycystic Kidney, Autosomal Dominant ,Kidney Transplantation ,Tissue Donors ,Surgery ,medicine.anatomical_structure ,Nephrology ,Cadaver ,Medicine ,Humans ,Cyst ,Organ donation ,business ,Kidney transplantation ,Kidney disease - Published
- 2001
35. 730 CONVENTIONAL SEROMARKERS FOR PREDICTION OF HEPATITIS B VIRUS-ASSOCIATED HEPATOCELLULAR CARCINOMA: AN EASY-TO-USE RISK SCORE
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Mei Hsuan Lee, San Lin You, Li Yu Wang, Chien-Chuan Chen, Sheng-Nan Lu, C.-L. Jen, Hwai I. Yang, and Yih Jyh Lin
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Hepatitis B virus ,medicine.medical_specialty ,Framingham Risk Score ,Hepatology ,business.industry ,Internal medicine ,Hepatocellular carcinoma ,medicine ,medicine.disease_cause ,business ,medicine.disease ,Gastroenterology - Published
- 2012
36. A RANDOMIZED, OPEN-LABEL, COMPARATIVE, MULTI-CENTER STUDY TO ASSES THE SAFETY AND EFFICACY OF PROGRAF/MYFORTIC AND ADVAGRAF/MYFORTIC IN DE NOVO LIVER TRANSPLANT RECIPIENTS— A PRELIMINARY REPORT
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Yih Jyh Lin, Long Bin Jeng, Horng Ren Yang, C. Hsieh, S. Cheng, and T. Chen
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Transplantation ,Pediatrics ,medicine.medical_specialty ,Preliminary report ,business.industry ,Multi center study ,medicine ,Open label ,Intensive care medicine ,business - Published
- 2010
37. Infusional 5-fluorouracil-based combination chemotherapy as first-line treatment for recurrent ampulla of vater cancer
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Sow-Hsong Kuo, C.-H. Hsu, Yih Jyh Lin, Po-Han Lin, Chun-Nan Lin, and Yu-Wen Tien
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Oncology ,Cancer Research ,medicine.medical_specialty ,business.industry ,Systemic chemotherapy ,Ampulla of Vater ,Cancer ,Combination chemotherapy ,medicine.disease ,Malignancy ,digestive system ,digestive system diseases ,First line treatment ,medicine.anatomical_structure ,Fluorouracil ,Internal medicine ,medicine ,In patient ,business ,medicine.drug - Abstract
e14673 Background: Ampulla of vater cancer (AVC) is a rare malignancy. Limited data are available regarding the efficacy of systemic chemotherapy in patients with recurrent or metastatic AVC. Infus...
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- 2010
38. ERRATUM
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Rita Bottino, A. N. Balamarugan, Xiaocheng Zhu, Stuart L. Houser, Yih Jyh Lin, Hao-Chih Tai, David K. C. Cooper, Mohamed Ezzelarab, and Hidetaka Hara
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medicine.medical_specialty ,Hepatology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Streptozotocin ,medicine.disease ,Endocrinology ,medicine.anatomical_structure ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,business ,Pancreas ,medicine.drug - Published
- 2008
39. Development of Laparoscopic Donor Nephrectomy: A Strategy to Increase Living Kidney Donation Incentive and Maintain Equivalent Donor/Recipient Outcome
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Chung-Jye Hung, Yih Jyh Lin, Po-Chang Lee, Tsung-Ching Chou, and Shen-Shin Chang
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Adult ,Male ,medicine.medical_specialty ,Tissue and Organ Procurement ,medicine.medical_treatment ,Renal function ,kidney transplantation ,living donor ,Nephrectomy ,Living Donors ,Humans ,Medicine ,Laparoscopy ,Kidney transplantation ,Medicine(all) ,lcsh:R5-920 ,Kidney ,Warm Ischemia Time ,medicine.diagnostic_test ,business.industry ,Graft Survival ,Kidney donation ,General Medicine ,Perioperative ,Length of Stay ,medicine.disease ,Surgery ,Treatment Outcome ,medicine.anatomical_structure ,open donor nephrectomy ,Tissue and Organ Harvesting ,Female ,lcsh:Medicine (General) ,business ,laparoscopic donor nephrectomy - Abstract
Background/Purpose: Laparoscopic donor nephrectomy (LDN) has emerged as the preferred technique worldwide, and has contributed to a dramatic increase in living kidney donation during the past decade. We adopted LDN in 2002 with the intention of increasing living kidney donation incentive and maintaining equivalent donor/recipient outcome. Methods: Forty-five LDNs were performed between September 2002 and November 2007. Donor demographics, operative characteristics, perioperative complications and donor/recipient outcome were reviewed retrospectively. The LDN series was divided into earlier and later groups for comparison. To confirm the safety and efficacy of LDN, we compared the results with those of previous series and our open donor nephrectomy (ODN) series. Results: All 45 LDN kidneys were procured and transplanted successfully. Mean donor operation time was 327.7±10.2 minutes, blood loss was 286.0±48.3 mL, and warm ischemia time was 233.9±19.6 seconds. Two (4.4%) open conversions happened in the earlier group. There was a significant decrease in warm ischemia time and donor intraoperative complications in the later group. There was no donor mortality and there were no repeat surgical procedures. Delayed graft function occurred in 8.9% of cases and three (6.7%) recipients developed ureteral complications. All but one recipient was discharged with adequate renal function. Graft function continued in 41 of the 43 harvested kidneys (95.3%). Compared with ODN, there was a significant decrease in donor postoperative stay in the LDN series (p = 0.00). There was no difference between the series with regard to donor safety, donor outcome, and immediate and long-term recipient outcome. Conclusion: The number of living kidney donations increased significantly after adopting LDN in our series. The equivalent donor/recipient outcome of the LDN series compared with that of previous and ODN series was achieved with increasing experience.
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40. Spironolactone-Induced Agranulocytosis: A Case Report
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May Ying Hsu, Ta Jen Wu, Shu Hwa Hsiao, and Yih Jyh Lin
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Adult ,medicine.medical_specialty ,Cirrhosis ,Diuresis ,Gastroenterology ,agranulocytosis ,chemistry.chemical_compound ,Internal medicine ,Ascites ,Humans ,Medicine ,Medicine(all) ,lcsh:R5-920 ,Leukopenia ,business.industry ,Furosemide ,General Medicine ,medicine.disease ,Endocrinology ,spironolactone ,chemistry ,Hepatocellular carcinoma ,Spironolactone ,Female ,medicine.symptom ,business ,lcsh:Medicine (General) ,medicine.drug - Abstract
A 43-year-old woman with liver cirrhosis and hepatocellular carcinoma was admitted for the chief problem of ascites. Laboratory data revealed a leukocyte count of 3.8 × 10 9 /L on the second day of admission. Spironolactone was prescribed for diuresis beginning on the third day. Routine blood tests on the tenth day disclosed marked leukopenia (1.8 × 10 9 /L). Four days later, the leukocyte count was still 1.8 × 10 9 /L and a differential count revealed agranulocytosis (neutrophils, 0.25 × 10 9 /L). Eight days after withdrawal of spironolactone, the leukocyte count returned to normal (leukocytes, 4.9 × 10 9 /L; neutrophils, 1.76 × 10 9 /L). On review of the patient's clinical condition, concurrent medication, and previous reports, we highly suspected that this episode of agranulocytosis was caused by spironolactone. Unlike four previously reported cases, this one did not involve furosemide, which is reported to be associated with leukopenia and agranulocytosis.
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