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Capecitabine Pattern of Usage, Rate of Febrile Neutropaenia and Treatment Related Death in Asian Cancer Patients in Clinical Practice

  • Phua, Vincent Chee Ee;Wong, Wei Quan;Tan, Pei Lin;Bustam, Anita Zarina;Saad, Marniza;Alip, Adlinda;Ishak, Wan Zamaniah Wan
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.4
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    • pp.1449-1453
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    • 2015
  • Background: Oral capecitabine is increasingly replacing intravenous 5-fluorouracil in many chemotherapy regimens. However, data on the risk of febrile neutropaenia (FN) and treatment related death (TRD) with the drug remain sparse outside of clinical trial settings despite its widespread usage. This study aimed to determine these rates in a large cohort of patients treated in the University of Malaya Medical Centre (UMMC). Materials and Methods: We reviewed the clinical notes of all patients prescribed with oral capecitabine chemotherapy for any tumour sites in University Malaya Medical Centre (UMMC) from $1^{st}$ January 2009 till $31^{st}$ June 2010. Information collected included patient demographics, histopathological features, treatment received including the different chemotherapy regimens and intent of treatment whether the chemotherapy was given for neoadjuvant, concurrent with radiation, adjuvant or palliative intent. The aim of this study is to establish the pattern of usage, FN and TRD rates with capecitabine in clinical practice outside of clinical trial setting. FN is defined as an oral temperature > $38.5^{\circ}C$ or two consecutive readings of > $38.0^{\circ}C$ for 2 hours and an absolute neutrophil count < $0.5{\times}10^9/L$, or expected to fall below $0.5{\times}10^9/L$ (de Naurois et al., 2010). Treatment related death was defined as death occurring during or within 30 days of last chemotherapy treatment. Results: Between $1^{st}$ January 2009 and $30^{th}$ June 2010, 274 patients were treated with capecitabine chemotherapy in UMMC. The mean age was 58 years (range 22 to 82 years). Capecitabine was used in 14 different tumour sites with the colorectal site predominating with a total of 128 cases (46.7%), followed by breast cancer (35.8%). Capecitabine was most commonly used in the palliative setting accounting for 63.9% of the cases, followed by the adjuvant setting (19.7%). The most common regimen was single agent capecitabine with 129 cases (47.1%). The other common regimens were XELOX (21.5%) and ECX (10.2%). The main result of this study showed an overall FN rate of 2.2% (6/274). The overall TRD rate was 5.1% (14/274). The FN rate for the single agent capecitabine regimen was 1.6% (2/129) and the TRD rate was 5.4% (7/129). All the TRDs were with single agent capecitabine regimen were used for palliative intent. Conclusions: Oral capecitabine is used widely in clinical practice in a myriad of tumour sites and bears a low risk of febrile neutropaenia. However, capecitabine like any other intravenous chemotherapeutic agent carries a significant risk of treatment related death.

Effect of microgrooves and fibronectin conjugation on the osteoblast marker gene expression and differentiation

  • Park, Su-Jung;Leesungbok, Richard;Ahn, Su-Jin;Im, Byung-Jin;Lee, Do Yun;Jee, Yu-Jin;Yoon, Joon-Ho;Cui, Taixing;Lee, Sang Cheon;Lee, Suk Won
    • The Journal of Advanced Prosthodontics
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    • v.7 no.6
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    • pp.496-505
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    • 2015
  • PURPOSE. To determine the effect of fibronectin (FN)-conjugated, microgrooved titanium (Ti) on osteoblast differentiation and gene expression in human bone marrow-derived mesenchymal stem cells (MSCs). MATERIALS AND METHODS. Photolithography was used to fabricate the microgrooved Ti, and amine functionalization (silanization) was used to immobilize fibronectin on the titanium surfaces. Osteoblast differentiation and osteoblast marker gene expression were analyzed by means of alkaline phosphatase activity assay, extracellular calcium deposition assay, and quantitative real-time PCR. RESULTS. The conjugation of fibronectin on Ti significantly increased osteoblast differentiation in MSCs compared with non-conjugated Ti substrates. On the extracellular calcium deposition assays of MSCs at 21 days, an approximately two-fold increase in calcium concentration was observed on the etched 60-${\mu}m$-wide/10-${\mu}m$-deep microgrooved surface with fibronectin (E60/10FN) compared with the same surface without fibronectin (E60/10), and a more than four-fold increase in calcium concentration was observed on E60/10FN compared with the non-etched control (NE0) and etched control (E0) surfaces. Through a series of analyses to determine the expression of osteoblast marker genes, a significant increase in all the marker genes except type I collagen ${\alpha}1$ mRNA was seen with E60/10FN more than with any of the other groups, as compared with NE0. CONCLUSION. The FN-conjugated, microgrooved Ti substrate can provide an effective surface to promote osteoblast differentiation and osteoblast marker gene expression in MSCs.

The Relationship of Froude Number and Developed Cloud Band Locations Near Yeongdong Region Under the Siberian High Pressure System (시베리아 고기압 영향으로 영동지역 부근에서 발달한 구름대의 위치와 Froude 수와의 관계)

  • Kim, Yu-Jin;Kim, Man-Ki;Lee, Jae Gyoo
    • Atmosphere
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    • v.29 no.3
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    • pp.325-342
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    • 2019
  • Precipitation and no-precipitation events under the influence of the Siberian high pressure system in Yeondong region, were analysed and classified as four types [obvious precipitation event (OP) type, obvious no-precipitation event (ON) type, ambiguous precipitation event (AP) type and ambiguous no-precipitation event (AN) type], according to the easiness in determining whether to have precipitation or not in Yeongdong region, to help in improving the forecast skill. Concerning the synoptic pressure pattern, for OP type, the ridge of Siberian high extends from Lake Baikal toward Northeast China, and there is a northerly wind upstream of the northern mountain complex (located near the Korean-Chinese border). On the other hand, for ON type, the ridge of Siberian high extends southeastward from Lake Baikal, and there is a westerly wind upstream of the northern mountain complex. The pressure pattern of AP type was similar to the OP type and that of AN type was also similar to ON type. Thus it was difficult to differentiate AP type and OP type and AN type and ON type based on the synoptic pressure pattern only. The four types were determined by U (wind speed normal to the Taebaek mountains) and Froude number (FN). That is, for OP type, average FN and U at Yeongdong coast are ~2.0 and ${\sim}6m\;s^{-1}$, and those at Yeongseo region are 0.0 and $0.1m\;s^{-1}$, respectively. On the contrary, for ON type, average FN and U at Yeongdong coast are 0.0 and $0.2m\;s^{-1}$, and those at Yeongseo region are ~1.0 and ${\sim}4m\;s^{-1}$, respectively. For AP type, average FN and U at Yeongdong coast are ~1.0 and ${\sim}4m\;s^{-1}$, and those at Yeongseo region are 0.0 and $0.2m\;s^{-1}$, whereas for AN type, average FN and U at Yeongdong coast are 0.1 and $0.6m\;s^{-1}$ and those at Yeongseo region are ~1.0 and ${\sim}3m\;s^{-1}$, respectively. Based on the result, a schematic diagram for each type was suggested.

Valvuloplasy in Mitral Regurgitation : available option in Young rheumatic mitral regurgitation patients (승모판막 폐쇄부전증에서 판막 성형술의 임상 분석: 젊은 류마티스성 승모판막 폐쇄부전증 환자에서의 판막 성형술)

  • 이재원;송태승;주석중;김종욱;송명근
    • Journal of Chest Surgery
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    • v.32 no.12
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    • pp.1093-1099
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    • 1999
  • 배경 : 류마티스성 승모판막 폐쇄부전증과 퇴행성 승모판막 폐쇄부전증에서 승모판막 성형술의 결과와 비교하여 류마티스성 승모판막 폐쇄부전증에서도 승모팍막성형술이 적합한 치료방법이 될 수 있는지를 알아보았다. 대상 및 방법 : 95년 1월부터 98년 12월 까지 승모판막 성형술을 시행받은 184명의 환자중에서 류마티스성 승모판막 폐쇄부전증 49례(1군)의 퇴행성 승모판막 폐쇄부전증 78례(2군)를 대상으로 하였다. 평균연령은 1군이 36.3$\pm$14.6(16-74세) 2군은 52.5$\pm$13.4(14-77)세였다 총 추적 관찰기간은 1군이 72.2인년 2군이77.2인년이었다 두군에서 수술후와 수술후 6개월 1년 및 이후 1년 단위로 주기적인 심초음파를 시행하였고 이를 통계적 검정하였다. 결과 : 두 군간에 수술전 혈류역학적인 차이를 보이지 않았고 수술전 평균 승모판막 폐쇄 부전의 정도는 1군이 3.0$\pm$0.4, 2군이 3.9$\pm$0.3였으나 수술후 추적 관찰에서 각각 0.9$\pm$0.9와 0.8$\pm$0.7정도의 양호한 판막 성형술의 결과를 보였고 승모판막 면적의 변화나 승모판막에서의 평균압력차이 등 혈류역학적인 결과에도 차이를 보이고 있지 않았다 수술조기 사망과 후기 사망은 없었으며 재수술율은 1군이 인년대비 1.4% 2군이 인년대비 2.6%였고 색전발생율은 1군이 인년대비 2.8% 2군이 1.3%였다. 심내막염발생은 1군에서만 1례있었으며 상기 결과들에서 두군간에 의미있는 차이를 보이고 있지는 않았다 결론 : 향후 장기적인 추적 관찰이 필요하나 중기 성적에서 승모판막 성형술이 류마티스성 승모판막 폐쇄 부전증에서도 효과적인 치료방법임을 알수 있었다.다 출생후 폐포막의 FN의 활성은 출생후 5일 및 7일에 최고주에 달했다. 출생직후 1-2일경에 혈관의 조직내 FN의 활성이 양성을 나타내지만 3일이후 활성이감소되었다. 폐포대식세포내 FN의 활성은 출생후 증가되었다. 폐조직내 소기관지의 FN의 활성은 출생후 완만하게 상승되었다. 큰 폐포세포는 출생 1-3일에 일정량의 FN 반응이 세포질과 미세융모내에 관찰되었다. 결론 : 이상과 같은 결과로 흰쥐의 폐포의 분화과정이 계속되는 출생후 폐에서 FN의 분비는 7일이내에 성숙흰쥐의 폐포내 반응과 비슷한 반응으르 보이며 이때 폐의 실질조직은 분화가 거의 완료되었을 것으로 사료되었고 큰 폐포세포에서도 FN이 분비되는 것으로 결론지울수 있다.X>에서 $1,332.75{\mu}g/mL$으로 최 대값을 나타내었으며, 추출시간 4.24시간 및 시료에 대한 용매비 9.71 mL/g에서 가장 높게 나타났다. 추출온도가 높고, 추출시간이 증가할수록 총 polyphenol 함량이 증가하는 경향을 나타내었다. Gallic acid 함량은 $65.84^{\circ}C$에서 $30.51{\mu}g/mL$으로 최대값을 나타내 었으며, 추출시간 1.65시간 및 시료에 대한 용매비 17.17mL/g에서 가장 높은 추출율을 보였다. Gallic acid 함량에 대한 추출조건의 영향은 추출시간과 용매비에 영향을 받는 것으로 나타났으며, 설정된 범위 내에서 온도에 대한 영향은 거의 나타나지 않는 것으로 나타났다. 실험연구가 더 필요하리라 본다. 혈액학적 변화를 유도하고 환자의 연령, 혈소판 수, 대동맥 차단 시간, 체외 순환 시간, 술후 PT 및 aPTT와 같은 다인적 상황들이 술후 출혈에 영향을 미친다는 점들을 시사하고

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Hydrodynamic Forces Acting on Porpoising Craft at High-Speed

  • Katayama, Toru;Ikeda, Yoshiho
    • Journal of Ship and Ocean Technology
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    • v.3 no.2
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    • pp.17-26
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    • 1999
  • An experimental investigation on hydrodynamic forces acting on a porpoising craft at high advanced speeds up to Froude numbers Fn=6.0(Fn=U\ulcorner:Lo\ulcorner denote overall length of ship) in calm water is performed. Captive model tests and forced motion tests are carried out to measure the hydrodynamic forces. The results show that significant nonlinear effects for motion amplitudes appear in the restoring, the added mass and the damping coefficients. The experimental results are compared with the results of a prediction method of the hydrodynamic forces include the nonlinear effects, and show a good agreement with them. A simulation using the predicted hydrodynamic forces in a nonlinear motion equation is carried out to obtain the porpoising motion of a craft in calm water. The calculated results are in fairly good agreement with experimental ones.

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A Study on the Degradation Mechanism due to FN Tunneling Carrier in MOS Device (MOS 소자의 FN 터널링 캐리어에 의한 성능 저하에 관한 연구)

  • 김명섭;박영준;민홍식
    • Journal of the Korean Institute of Telematics and Electronics A
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    • v.30A no.2
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    • pp.53-63
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    • 1993
  • Device degradations by the Fowler-Nordheim tunneling have been studide. The changes of device characteristics such as the threshold voltage, subthreshold slope, I-.or. curves have been measured after bidirectionally stressing n-channel MOSFET's and p-channel MOSFET's. Also the interface states have been directly measured by the charge pumping methodIt is shown that the change of interface states is determined by the number of hole carriers tunneling the gate oxide and electrons which are trapped in the gate oxide. Also, in this paper, we propose a model for device lifetime limited by the increase of interface states.

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Experimental Analysis for Variation of Pressure Difference on Flooding in PEM Fuel Cell at Cathode Channel Outlet (Cathode 출구 압력 변화에 따른 PEM Fuel Cell 내에서의 플러딩에 관한 실험적 연구)

  • Ahn, Deuk-Keun;Han, Seong-Ho;Kim, Kyoung-Rock;Choi, Young-Don
    • Journal of Hydrogen and New Energy
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    • v.20 no.5
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    • pp.390-396
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    • 2009
  • The flooding, especially in channel, is one of the critical issue to put proton exchange membrane fuel cell (PEMFC) to practical use. In this paper, channel flooding was investigated the pressure difference at cathode channel outlet. A ratio of pressure difference changes to 25, 50% as its variation rate. The pressure variable rate is reflected in dimensionless number FN. As a result, modified dimensionless number $FN^*$ correctly predicted the channel flooding. This study analyzes that a variety of pressure difference is how to affect flooding at the cathode of the PEMFC.

Functional Neuromuscular Stimulation for Paraplegic Standing (FNS를 사용한 하반신마비자의 일어서기)

  • Khang, Gon
    • Journal of Biomedical Engineering Research
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    • v.11 no.1
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    • pp.1-4
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    • 1990
  • An implementation scheme of the magnetic nerve stimulator using a switching mode power supply is proposed. By using a switching mode power supply rather than a conventional linear power supply for charging high voltage capacitors, the weight and size of the magnetic nerve stimulator can be considerably reduced. Maximum output voltage of the developed magnetic nerve stimulator using the switching mode power supply is 3,000 volts and switching time is about 100 msec. Experimental results or human nerve stimulations using the developed stimulator are presented.

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