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2. The Induced Membrane Technique for the Management of Segmental Tibial Defect or Nonunion: A Systematic Review and Meta-Analysis

Author

Hsu, Chen-An, Chen, Shih-Heng, Chan, Soa-Yu, and Yu, Yi-Hsun

Subjects
Article Subject, musculoskeletal system
Abstract

Purpose. To identify the predicting factors for union and infection after applying the induced membrane technique (IMT) for segmental tibial defects. Methods. A systematic review was carried out following the PRISMA guidelines. All databases were searched for articles published between January 2000 and February 2018 using the keywords “Masquelet technique” and “induced membrane technique.” Studies in English reporting more than 5 cases with accessible individual patient data were included. A meta-analysis was performed. Odds ratios (OR) with 95% confidence intervals were calculated. Results. After reviewing, 11/243 studies (115 patients) were finally selected. The mean age of the patients was 43.6 years (range: 18-84 years), and the mean length of the tibial defect was 5.5 cm (range: 0-20 cm). The multivariate logistic regression analysis revealed that the risk factors of postoperative infection after IMT were infected nonunion (p=0.0160) and defect length ≥7 cm (p=0.0291). Patients with postoperative infection after IMT had a lower union rate (p=0.0003). Additionally, the use of an antibiotic polymethyl methacrylate cement spacer reduced the need for surgical revision (p=0.0127). Multiple logistic regression indicated no direct association between the union rate and length of the bone defect. Conclusions. IMT is a reliable and reproducible treatment for segmental tibial defects. However, initial infected nonunion and defect length greater than 7 cm are risk factors for post-IMT infection, and post-IMT infection was statistically related to nonunion.

Published
2020
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3. Risk of hepatitis C virus related hepatocellular carcinoma between subjects with spontaneous and treatment-induced viral clearance

Author

Huang, Chung-Feng, primary, Yeh, Ming-Lun, additional, Huang, Ching-I, additional, Lin, Yu-Ju, additional, Tsai, Pei-Chien, additional, Lin, Zu-Yau, additional, Chan, Soa-Yu, additional, Chen, Shinn-Cherng, additional, Yang, Hwai-I, additional, Huang, Jee-Fu, additional, Lu, Sheng-Nan, additional, Dai, Chia-Yen, additional, Jen, Chin-Lan, additional, Yuan, Yong, additional, L’Italien, Gilbert, additional, Wang, Li-Yu, additional, Lee, Mei-Hsuan, additional, Yu, Ming-Lung, additional, Chuang, Wan-Long, additional, and Chen, Chien-Jen, additional

Published
2017
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7. Life expectancies and incidence rates of patients under prolonged mechanical ventilation: a population-based study during 1998 to 2007 in Taiwan

Author

Hung, Mei-Chuan, primary, Lu, Hsin-Ming, additional, Chen, Likwang, additional, Hu, Fu-Chang, additional, Chan, Soa-Yu, additional, Yan, Yuan-Horng, additional, Fan, Po-Sheng, additional, Lin, Ming-Shian, additional, Chen, Cheng-Ren, additional, Kuo, Lu-Cheng, additional, Yu, Chong-Jen, additional, and Wang, Jung-Der, additional

Published
2011
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8. Clinical characteristics of advanced hepatocellular carcinoma patients with prolonged survival in the era of anti-angiogenic targeted-therapy.

Author

Lu LC, Shao YY, Chan SY, Hsu CH, and Cheng AL

Subjects
Adult, Aged, Aged, 80 and over, Carcinoma, Hepatocellular blood supply, Clinical Trials, Phase III as Topic, Cohort Studies, Disease-Free Survival, Female, Humans, Liver Neoplasms blood supply, Male, Middle Aged, Neovascularization, Pathologic drug therapy, Randomized Controlled Trials as Topic, Young Adult, Angiogenesis Inhibitors therapeutic use, Carcinoma, Hepatocellular drug therapy, Liver Neoplasms drug therapy
Abstract

Background: The prognosis of patients with advanced hepatocellular carcinoma (HCC) is poor despite treatment with sorafenib or other anti-angiogenic targeted-therapies. Patients with advanced HCC with prolonged survival may exhibit unique clinical characteristics., Patients and Methods: We reviewed patients with Barcelona Clinic Liver Cancer stage C HCC, who were enrolled in six clinical trials for first-line anti-angiogenic targeted-therapy between May 2005 and December 2010 in a single Institute. Patients with prolonged survival were identified as those who exhibited overall survival (OS) of more than two years; their clinical variables were analyzed., Results: Of the 189 enrolled patients, 22 (11.6%) patients with prolonged survival were identified. Their median OS was 58.7 (range=24.6-88.4) months, compared to an OS of 7.1 months for the overall patient cohort. A multivariate analysis showed that the patients with prolonged survival were less likely to have chronic hepatitis B virus infection, α-fetoprotein level >400 ng/ml, and liver involvement than were the remaining patients. In addition, the patients with prolonged survival experienced significantly higher response rates (50.0%) and disease control rates (86.4%) to the first-line targeted-therapy, and received more additional therapies than did the other patients. Seven patients remained disease-free for a median of 27.0 (range, 4.5-64.6) months after receiving additional locoregional therapies., Conclusion: Patients with advanced HCC who experienced prolonged survival exhibited certain clinical features and strong treatment responses to first-line anti-angiogenic targeted-therapies. Additional locoregional therapies could contribute to the long-term disease-free status in selected patients.

Published
2014

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