Kaohsiung, Taiwan
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Chen Y.-C.,Kaohsiung Medical Center | Wang P.-W.,Chang Gung University | Pan T.-L.,Chang Gung University | Bazylak G.,Nicolaus Copernicus University | And 2 more authors.
Combinatorial Chemistry and High Throughput Screening | Year: 2010

In a variety of countries, juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in childhood, yet its etiology is still unknown. In recent years, etanercept, an effective inhibitor of tumor necrosis factor alpha (TNF-α), was used as an alternative in certain oligoarticular JIA patients resistant to conventional nonsteroidal antiinflammatory drugs (NSAIDs), disease-modifying anti-rheumatic drugs (DMARDs), and corticosteroid therapies, and it resulted in sustained improvement in JIA symptoms. This pilot study explores the alterations of specific panels of cytokines and protein profiles in plasma for two Taiwanese pediatric cases with diagnosed enthesitis-related arthritis (ERA), a type of JIA. The patients were studied before and after taking etanercept alone, using a high-content screening approach employing membrane-based human cytokine antibody microarray and the conventional two-dimensional gel electrophoresis (2-DE) proteomic technique. Specifically, 2-DE in combination with mass spectrometry (MALDI-MS) revealed the functional roles of plasma proteins associated with the regulation of immune responses during short-term etanercept treatment of children with ERA. Our study shows that this biotherapy improved clinical ERA manifestations through the regulation of inflammatory mediators, including several cytotoxic cellular cytokines (IL-2/IFN-γ), chemokines (MCP-1), and growth factors (GRO) that affect the expression of specific acute phase proteins such as haptoglobins, immunoglobulin A, and fibrinogen-γ chain. Meanwhile, an up-regulation of antithrombin chain I, vitamin-D binding protein (VDBP), and the various apolipoproteins was also observed after the administration of etanercept in both studied children. These results may be interpreted as the relevant predictive biomarkers of therapeutic responses to etanercept. They suggest that etanercept, which is still rarely used in Taiwan, is a viable treatment for JIA patients, without adverse health effects and increased risk of secondary infections. © 2010 Bentham Science Publishers Ltd.

Hsu C.-C.,Chang Gung Memorial Hospital | Wu C.-E.,Chang Gung Memorial Hospital | Chen J.-S.,Chang Gung Memorial Hospital | Tseng J.-H.,Chang Gung Memorial Hospital | And 9 more authors.
Anticancer Research | Year: 2014

Aim: Imatinib mesylate (IM) is effective in metastatic gastrointestinal stromal tumor (GIST) patients; however, disease progression eventually occurs due to IM resistance or intolerance. Treatment options include IM escalation or a direct shift to sunitinib, but comparison of these strategies is required. Patients and Methods: This study included 91 out of 214 metastatic GIST patients treated with IM, who experienced progression or intolerance between August 2001 and December 2012 at the Chang Gung Memorial Hospital. Treatment efficacy and safety profiles were retrospectively compared between groups of patients who either received escalated IM or were directly switched to sunitinib. Results: There were no significant differences in age, gender, second-line treatment causes or gene mutations in the IM escalation group (N=63) versus the sunitinib group (N=28). The 2 groups had similar progression-free survival (PFS, p=0.316) and overall survival (OS, p=0.599). Patients without primary KIT exon 9 mutations and who treated with sunitinib had significantly better PFS (14.3 vs. 6.2 months, p=0.037) and a trend toward better OS (not reached vs. 16.4 months, p=0.161) compared to the IM-escalation group. Patients in both groups with responses and stable disease (SD), and IM escalation patients who underwent surgery and who had KIT exon 9 mutations, had favorable PFS. The most common non-hematological adverse events were edema in the IM escalation group and hand-foot syndrome and hypertension in the sunitinib group. Conclusion: Comparable results were achieved by IM escalation and sunitinib treatment. Physicians should consider kinase mutations and specific adverse effects when choosing between these treatments. © 2014, International Institute of Anticancer Research. All rights reserved.

PubMed | Kaohsiung Medical Center
Type: Case Reports | Journal: Hepato-gastroenterology | Year: 2012

Living related liver transplantation (LRLT) may not be the only treatment for recurrent bleeding due to severe gastric varices secondary to left-side portal hypertension and splenic vein thrombosis. Splenectomy is the preferred long-term standard treatment for non-orthotopic liver transplantation patients, but additional treatments such as post-transplantation partial splenic arterial embolization to preserve the immunological function of the spleen and thus prevent the occurrence of post LRLT severe infection are suggested for these patients.

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