Safety and efficacy of fimasartan with essential hypertension patients in real world clinical practice: data from a post marketing surveillance in Korea

The safety and efficacy of fimasartan have been evaluated through post-marketing surveillance in real world clinical practice. The multi-center, prospective, open-label and non-interventional study. A total of 3,945 patients (3,729 patients for safety assessment and 3,473 patients for efficacy assessment) were screened in patients with essential hypertension in 89 study centers from 9 September 2010 through 8 September 2016. Among the total patients, 2,893 patients (77.6%) were administered fimasartan for 24 weeks or longer and were classified as ‘patients with long-term follow-up’, and the additional safety and efficacy analysis were performed. The improvement was defined as systolic blood pressure (SBP) controlled to ≤ 140 mmHg or decreased SBP differences ≥ 20 mmHg after treatment or diastolic blood pressure (DBP) controlled to ≤ 90 mmHg or decreased DBP differences ≥ 10 mmHg after treatment. Adverse drug reactions (ADRs) were reported in 3.8% patients; dizziness, and hypotension were the most frequently reported ADRs in total patients. The results of patients with long-term follow-up were comparable with total patients. The overall improvement rate in all efficacy assessment at the last visit was 87.1% (3,025/3,473 patients). The overall improvement rate of the patients with long-term follow-up was 88.9%. Fimasartan was well tolerated, with no new safety concerns identified and an effective treatment in the real world clinical practice for Korean patients with hypertension.

Antivascular Therapy via Inhibition of Receptor Tyrosine Kinases in an Orthotopic Murine Model of Salivary Adenoid Cystic Carcinoma

PURPOSE: We evaluated the therapeutic effect of AEE788, a dual inhibitor of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) receptor tyrosine kinases on human salivary adenoid cystic carcinoma (ACC) cells growing in nude mice. Experimental Design: We examined the effects of AEE788 on salivary ACC cell growth and apoptosis. To determine the in vivo effects of AEE788, nude mice with orthotopic parotid tumors were randomized to receive oral AEE788 (50 mg/kg) three times per week, injected paclitaxel (200 microgram) once per week, AEE788 plus paclitaxel, or placebo. Mechanisms of in vivo AEE788 activity were determined by immunohistochemical analysis. RESULTS: Treatment of salivary ACC cells with AEE788 led to growth inhibition and induction of apoptosis. AEE788 inhibited tumor growth and prevented lung metastasis in nude mice. Furthermore, AEE788 potentiated growth inhibition and apoptosis of ACC tumor cells mediated by paclitaxel. Tumors of mice treated with AEE788 and AEE788 plus paclitaxel exhibited down-regulation of activated EGFR and its downstream mediators (Akt and MAPK), increased tumor and endothelial cell apoptosis, and decreased microvessel density, which correlated with a decrease in the level of MMP-9, MMP-2 and bFGF expression and a decrease in the incidence of vascular metastasis. CONCLUSIONS: These data show that tumor-associated endothelial cells are important in the process of tumor-metastasis. And VEGFR can be a molecular target for therapy of metastatic lung lesion of salivary ACC.

Radiologic Evaluation of Intestinal Obstruction in the Neonates

PURPOSE: The purpose of this study is to evaluate the radiologic findings of the intestinal obstruction in the neonate according to the causes and to determine the findings useful for the differential diagnosis. MATERIALS AND METHODS: The materials consisted of 29 neonates with surgically proven gastrointestinal tract obstruction. We analized simple abdominal radiography and barium study comparing with the operative findings. RESULTS: The causes of intestinal obstruction were gastric atresia in 1 case, duodenal atresia in 3 cases, small bowel atresia in 11 cases(jejunal ;3 cases, ileal ;8 cases), colonic atresia in 2 cases, Hirschsprung's disease in 9 cases, ano-rectal anomaly in 6 cases, midgut volvulus in 2 cases, and Meckel's diverticulum in 1 case. Vomiting was noted in the all cases. The abdominal distension was not noted in the cases of gastric atresia, duodenal atresia, and proximal jejunal atresia. The meconium passage was noted in 2 cases of ileal atresia and 3 cases of Hirschsprung's disease. On barium study, site of obstruction was predicted accurately in gastric atresia, duodenal atresia, proximal jejunal atresia, and colonic atresia but it was not possible in distal jejunal atresia and ileal atresia. The microcolon was noted in 2 cases of jejunal atresia, 4 cases of ileal atresia, and 2 cases of colonic atresia. Out of 9 Hirschsprung's disease transition zones were seen on rectum or rectosigmoid junction in 7 cases and barium study was normal in 2 cases. CONCLUSION: In the diagnosis of neonatal intestinal obstruction, the basic radiologic studies such as simple abdominal radiography and gastrointestinal contrast study was useful for the differential diagnosis of the proxireal bowel loop atresia colonic ateria, and midgut volvulus.

CT and MR Findings of Chest Wall Masses

PURPOSE: To evaluate the characteristic radiological findings of various diseases forming chest wall masses by CT and MR. MATERIALS AND METHODS: We retrospectively reviewed CT and MR findings of the chest wall masses in 31 patients. Morphology, density, features of contrast enhancement, and location of the mass within the bony thorax or soft tissue were analyzed. RESULTS: Benign lesions of bony thorax were osteochondritis(n=2), tuberculosis(n=1), and osteochon droma (n=l). Malignant lesions of bony thorax were Ewing's sarcoma(n=I) and metastasis(n=3). Benign lesions of soft tissue were abscess(n=1), tuberculosis(n=7), lipoma(n=l), cavernous hemangioma(n=2), cavernous lymphangioma(n=1), and neurofibroma(n=l). Malignant lesions of soft tissue were lymphoma(n=l), spindle cell sarcoma(n=1), metastasis(n=8). Tuberculosis of the chest wall (n=8) were ill-defined hypodense(n=7) or isodense(n=l) mass than surrounding muscle on pre-enhanced CT scan. All massess showed peripheral rim enhancement after contrast enhancement. Five cases were associated with pulmonary or pleural tuberculosis. All malignant lesions of bony thorax showed bone destruction, but inflammatory processes also showed bone destruction. MR showed characeristic signal intensity in the case of lipoma(n=l) and hemangioma(n=l). CONCLUSION: We conclude that CT and MR are helpful for differential diagnosis of chest wall masses.