Tarng Y.-W.,Kaohsiung Veterans General Hospital |
Liu Y.-Y.,Kaohsiung Veterans General Hospital |
Huang F.-D.,Kaohsiung Veterans General Hospital |
Lin H.-L.,Fooying University Hospital |
And 6 more authors.
Surgical Endoscopy and Other Interventional Techniques
Background: Blunt chest injuries are usually combined with multiple rib fractures and severe lung contusions. This can occasionally induce acute respiratory failure and prolong ventilations. In order to reduce the periods of ventilator dependency, we propose a less invasive method of fixing multiple rib fractures. Methods: Since October 2009, we have developed a new method to fix fractured ribs caused by blunt trauma. Rib fixations were performed using 2.0- or 2.5-mm intramedullary titanium elastic nails (TEN), with the help of video-assisted thoracoscopic surgery (VATS) and minimal thoracic incisions. All the patients’ demographics and postoperative data were collected. Results: From January 2010 to December 2012, a total of 65 patients presenting with multiple rib fractures resulting in acute respiratory failure were included in the study. Twelve patients received the new surgical fixation. Rib fixations were performed at an average of 4 days after trauma. Patients were successfully weaned off ventilators after an average of 3 days. The average length of stay in the hospital and the intensive care unit (ICU) was shorter for the patients with fixation than for nonsurgical patients. All twelve patients returned to normal daily activities and work. Conclusions: In the reconstruction of an injured chest wall, the VATS with TENs fixation in multiple rib fractures is feasible. This method is also effective in decreasing the length of the surgical wound. Because the structure of the chest cage is protected, the period of mechanical ventilation is shortened and the length of stay in the hospital and the ICU can be reduced. © 2015, The Author(s). Source
Wu H.-J.,National Sun Yat - sen University |
Liu H.-C.,National Sun Yat - sen University |
Liu H.-C.,Fooying University Hospital |
Chang Y.-T.,Kaohsiung Municipal Hsiao Kang Hospital |
And 2 more authors.
Biomarkers and Genomic Medicine
Colorectal cancer is a common gastrointestinal malignancy. Radiation combined with chemotherapy (also known as concurrent chemoradiotherapy or CCRT) is often used prior to surgery for treating severe cases of colorectal cancer. However, responses of individual tumors to CCRT differ. Therefore, in light of the variability in radiation sensitivity among different tumors, identifying the factors that can be applied to predict CCRT efficacy prior to treatment will aid in making decisions regarding an appropriate treatment strategy. In the present study, we used a gene chip to analyze the expression of candidate genes in the tumor cells of colorectal cancer patients prior to and after treatment with CCRT, in order to identify molecular markers that can predict the efficacy of CCRT. First, we selected a total of 15 CCRT candidate genes based on the results of previous studies, which used the microarray method to select CCRT response-related genes that were also related to tumor malignancy. We collected preoperative CCRT tumor tissues from 17 colorectal cancer patients for whom the efficacy of CCRT had already been determined and used gene chips to analyze the expression of CCRT-related genes in the tissues of these patients. We then compared the results for the expression of CCRT-related genes with those for the clinical efficacy of CCRT. Of the 15 candidate genes, five genes (. CK-20, ELAVL4, EV12B, TM4SF3, and ATPA2) were upregulated in>29.4% and one gene (. MET) was downregulated in 23.5% of the total patients after treatment with CCRT, indicating that these genes may be potential predictive markers for CCRT efficacy. © 2014. Source