Kim, Jong-Sik;Jung, Chun-Young;Oh, Dong-Gyoon;Song, Ki-Won;Park, Young-Hwan
The Journal of Korean Society for Radiation Therapy
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v.18
no.1
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pp.13-19
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2006
Purpose: To evaluate whether modified MUPIT applicator can effectively eradicate recurrent tumor in uterine cervix cancer and reduce rectal complication after complete radiation treatment. Materials and Methods: Modified MUPIT applicator basically consists of an acrylic cylinder with flexible brain applicator, an acrylic template with a predrilled array of holes that serve as guides for interstitial needles and interstitial needles. CT scan was peformed to determine tumor volume and the position of interstitial needles. Modified MUPIT applicator was applied to patient in operation room and the accuracy for position of interstitial needles in tumor volume was confirmed by CTscan. Brachytherapy was delivered using modified MUPIT applicator and RALS(192-lr HDR) after calculated computer planning by orthogonal film. The daily dose was 600cGy and the total dose was delivered 3,000 cGy in tumor volume by BID. Rectal dose was measured by TLD at 5 points so that evaluated the risk of rectal complication. Results: The application of modified MUPIT applicator improved dramatically dose distributions in tumor volume and follow-up of 3 month for this patient was clinically partial response without normal tissue complication, Rectal dose was measured 34.1 cGy, 57.1 cGy, 103.8 cGy, 162.7 cGy, 165.7 cGy at each points, especially the rectal dose including previous EBRT and ICR was 34.1 cGy, 57.1 cGy. Conclusion: Patients with locally recurrent tumor in uterine cervix cancel treated with modified MUPIT applicator can expect reasonable rates of local control. The advantages of the system are the fixed geometry provided by the template and cylinders. and improved dose distributions in irregular tumor volume without rectal complication.
To determine the effectiveness of radiotherapy for pain control in metastatic bone disease, we retrospectively analyzed the treatment results in 126 patients who received short-course radiotherapr(2,000 rad/1wk vs 3,000 rad/2wks) in the Department of Therapeutic Radiology, Seoul National University Hospital from Feb. 1979 to July 1983. Pain relief was obtained in $82\%$ of patients and complete Pain relief was obtained in $35.3\%$ of patients. The incidence of metastatic bone tumor was highest in spine and pelvis, $43.7\%\;and\;26.3\%$>, respectively. Primary sites of metastasia were lung, breast, unknown primary, stomach, uterine cervix, in order of frequency. There was no significant difference in the response to treatment between 2,000 rad in 1 week and 3,000 rad in 2 weeks.
An esophageal leiomyoma is the most common benign tumor of the esophagus mainly occurred in intramural portion. Occasionaly, it is difficult to discriminate esophageal malignancy from large leiomyoma. Although F-18 FDG PET has been used for differentiating malignant from benign disease, false-positive cases have been reported. Recently, uterine leiomyoma has been reported to have relatively high F-18 FDG uptake in some patients but little is known about how an esophageal leiomyoma might be showed on F-18 FDG PET. We report a case of esophageal leiomyoma that showed high FDG uptake on PET images.
The methanol (MeOH) extract of the rhizome of Alpinia officinarum Hance (Zingiberaceae) demonstrated a potent inhibition on the proliferation of cultured human tumor cell lines such as MES-SA (human uterine carcinoma cell line), MESSA/DX5 (multidrug resistant subline of MES-SA), HCT-15 (human colorectal adenocarcinoma cell line), HCT15/CL02 (multidrug resistant subline of HCT15). The MeOH extract was fractionated into four portions by serial solvent partition, ie., methylene chloride (CH2Cl2) soluble part, ethylacetate (EtOAc) soluble part, n-butanol (BuOH) soluble part and remaining water layer. Among them, the $CH_2Cl_2$ soluble part of the extract exhibited a most potent inhibition on the proliferation of tested tumor cell lines. Bioassay-guided fractionation of the $CH_2Cl_2$ soluble part led to the isolation of five diarylheptanoid and two flavonoid constituents, i. e., galangin (1), 7-(4"-hydroxy-3"-methoxyphenyl)-1-phenylhept-4-en-3-one (2), 1,7-diphenyl-5-hydroxy-3-heptanone (3), trans,trans-1-(3'-methoxy-4'-hydroxyphenyl)-7-phenyl-5-ol-4,6-dien-3-heptanone (4), 5-methoxy-7-(4"-hydroxy-3"-methoxyphenyl)-1-phenyl-3-heptanone (5), kaempferide (6), 5-hydroxy-7-(4"-hydroxy-3"-methoxyphenyl)-1-phenyl-3-heptanone (7). Structures of the isolated active components (1 - 7) were established by chemical and spectroscopic means.
Purpose: We designed this study to identify and suggest the reasonable timing of adjuvant radiotherapy in the treatment of uterine carcinosarcoma according to the surgical intent and patterns of progression. Materials and Methods: We retrospectively analyzed a total of 50 carcinosarcoma patients diagnosed between 1995 and 2010. Among these 50 patients, 32 underwent curative surgery and 13 underwent maximal tumor debulking surgery. The remaining five patients underwent biopsy only. Twenty-six patients received chemotherapy, and 15 patients received adjuvant radiotherapy. Results: The median follow-up period was 17.3 months. Curative resection (p < 0.001) and stage (p < 0.001) were statistically significant factors affecting survival. During follow-up, 30 patients showed progression. Among these, eight patients (16.0%) had loco-regional progression only. The patients who had received adjuvant radiotherapy did not show loco-regional progression, and radiotherapy was a significant negative risk factor for loco-regional progression (p = 0.01). The time to loco-regional progression was much earlier for non-curative than curative resection (range, 0.7 to 7.6 months vs. 7.5 to 39.0 months). Conclusion: Adjuvant radiotherapy in the treatment of carcinosarcoma might be related to a low loco-regional progression rate. Radiotherapy should be considered in non-curatively resected patients as soon as possible.
This is a retrospective cohort analysis of 58 patients who treated with postoperative radiation therapy following radical hysterectomy and bilateral pelvic adenectomy for early stage carcinoma of uterine cervix between January 1988 and December 1990 at department of radiation oncology, Keimyoung University Hospital. Sixteen percent of patients (9/58) had chemotherapy. Most patients were FIGO I b (47 patients), and FIGO I a and II a were one and ten patients, respectively. The median follow-up periods were 48.5 months. The indications for radiation therapy included pelvic lymph node metastasis, large tumor size, deep stromal invasion, lymphovascular invasion, positive surgical margin, endometrial invasion and parametrial invasion. Eighty five percent of the patients had more than one risk factor. The actuarial overall five year survival rate (5 YSR) and five year disease free survival rate (5 YDFSR) were $89.5\%,\;and\;87.8\%,$ respectively. Their overall recurrence rate was $12.1\%,$(758). Distant metastasis was the most common cause of treatment failure $(71.4\%:5/7).$ The univariate analysis of prognostic factors affecting to five year survival rate disclosed pelvic lymph node status (negative: $95.5\%,\;positive:69.2\%,$ p=0.006) and hemoglobin level $(\le11 :75\%,>11g/dl:93.3\%,p=0.05)$ as significant factor. The age status was marginally significant $(\le40:96.0\%,\;>\;40:84.3\%p=0.15).$ Multivariate analysis clarified three independent prognostic factors: pelvic lymph node metastasis (p=p.006), hemoglobin level (p=0.015) and age (p=0.035). Multivariate analysis of prognostic factor affecting to five year disease free survival rate disclosed pelvic lymph node status (p=0.0078) and status of surgical margin (p=0.008). Complications relating to radiotherapy were $10.3\%,(6/58).$ There were no severe major complication requiring surgical intervention or a long hospital stay. It is our opinion that the benefit of postoperative pelvic radiotherapy may be gained in such a high risk patient population with acceptible morbidity.
Kim, Cheul-Hong;Jeong, Seong Soon;Park, Soon Ji;Choi, Eun-Ji;Kim, Yeon Ha;Ahn, Ji-Hye
Journal of Dental Anesthesia and Pain Medicine
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v.19
no.5
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pp.253-260
/
2019
Background: Sometimes general anesthesia is required for dental surgery in pregnant women. Facial bone fractures or neck abscess should be treated immediately. Dental surgery, however, creates a stressful situation that can cause inflammation. Inflammatory responses are a well-known major cause of preterm labor and preterm birth. Here we demonstrate the effects of remifentanil on the factors related to preterm labor and its mechanism of action on amniotic-derived epithelial cells (WISH cells). Methods: WISH cells were exposed to lipopolysaccharide (LPS) for 24 h and co-treated with various concentrations of remifentanil. MTT assays were performed to measure cell viability. To explain the effects of remifentanil on the factors related to inflammation in WISH cells, activation of nuclear factor kappa B ($NF-{\kappa}B$) and p38 and the expression of interleukin $(IL)-1{\beta}$, tumor necrosis factor $(TNF)-{\alpha}$, cyclooxygenase (COX)2, and prostaglandin E $(PGE)_2$ were quantified using western blotting and RT-PCR, respectively. Results: Remifentanil did not affect WISH cell viability. In western blot analysis, co-treatment with remifentanil resulted in decreased phosphorylation of $NF-{\kappa}B$, and expression of COX2 and $PGE_2$ in LPS-induced inflammation, but the results were statistically significant only at low concentrations. Reduction of $IL-1{\beta}$ and $TNF-{\alpha}$ expression was also observed with RT-PCR. Conclusion: Co-treatment with remifentanil does not affect the viability of WISH cells, but reduces the expression of the factors related to inflammation, which can induce uterine contraction and preterm labor. These findings provide evidence that remifentanil may inhibit uterine contraction and preterm labor in clinical settings.
Meligy, Fatma Y.;Elgamal, Dalia A.;Abdelzaher, Lobna A.;Khashbah, Maha Y.;El-Mokhtar, Mohamed A.;Sayed, Ayat A.;Refaiy, Abeer M.;Othman, Essam R.
Clinical and Experimental Reproductive Medicine
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v.48
no.4
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pp.322-336
/
2021
Objective: Endometriosis is a chronic debilitating inflammatory condition characterized by the presence of endometrial tissues outside the uterine cavity. Pelvic soreness and infertility are the usual association. Due to the poor effectiveness of the hormone therapy and the high incidence of recurrence following surgical excision, there is no single effective option for management of endometriosis. Mesenchymal stem cells (MSCs) are multipotent stromal cells studied for their broad immunoregulatory and anti-inflammatory properties; however, their efficiency in endometriosis cases is still a controversial issue. Our study aim was to evaluate whether adipose tissue-derived MSCs (AD-MSCs) could help with endometriosis through their studied anti-inflammatory role. Methods: Female Wistar rats weighting 180 to 250 g were randomly divided into two groups: group 1, endometriosis group; established by transplanting autologous uterine tissue into rats' peritoneal cavities and group 2, stem cell treated group; treated with AD-MSCs on the 5th day after induction of endometriosis. The proliferative activity of the endometriosis lesions was evaluated through Ki67 staining. Quantitative estimation of interferon γ, tumor necrosis factor-α, interleukin (IL)-6, IL-1β, IL-10, and transforming growth factor β expression, as well as immunohistochemical detection of CD68 positive macrophages, were used to assess the inflammatory status. Results: The size and proliferative activity of endometriosis lesions were significantly reduced in the stem cell treated group. Stem cells efficiently mitigated endometriosis associated chronic inflammatory reactions estimated through reduction of CD68 positive macrophages and the expression of the proinflammatory cytokines. Conclusion: Stem cell therapy can be considered a novel remedy in endometriosis possibly through its anti-inflammatory and antiproliferative properties.
Purpose : Because adenocarcinomas of the uterine cervix have lower 5-year survival rate than squamous cell carcinomas due to early lymph node metastasis and local extension, scrutiny of lymph node metastasis and local extension by radiologic examination is necessary in case of clinically diagnosed or suspected adenocarcinomas. The purpose of this study is to evaluate whether there are specific findings of these tumors, compared with squamous cell carcinomas, through the analysis of magnetic resonance (MR) imaging findings. Materials and Methods : Of 21 pathologically proven cervical adenocarcinomas, MR imaging findings of 18 tumors (histologic staging : two Ib, four IIa, two IIb, one IIIa, and one IIIb) were retrospectively analyzed and compared with those of 40 wquamous cell carcinoma in consecutive patients as a control group. T1-wetighted and fast spin echo T2-weighted images were obtained on the axial and sagittal planes, using a 1.5-T MR scanner. The largest diameter, location, signal intensity and degree of contrast enhancement contour, shape and longitudinal extent of the tumor and associated findings on MR image were analyzed. Results : The largest diameters of cervical adenocarcinomas ranged from 0.8 to 4.1 cm(mean, 2.2 cm). Of 18 adenocarcinomas, nine were of endocervical type. All adenocarcinomas were isointense to surrounding cervical stroma on T1-weighted images and hyperintense(homogeneous in ten, inhomogeneous in eight) on fast spin echo T2-weighted images. Adenocarcinomas enhanced on contrast study in all patients (homogeneous in six, inhomogeneous in 12 with hyperintese enhnacing rim in two). Eight adenocarcinomas had smooth contours and ten had irregular ones. The shape of adenocarcinoma was irregular in eight patients, barrel shape in six, papillary/polypod in three, and nodular in one. All adenocarcinomas involved lower half of the uterine cervix and six tumors extended up to the upper half. Pelvic lymph nodes of more than 1.5cm in diameter in two adenocarcinomas pateints and no detectable small pelvic lymph nodes on MR imaging in one patient were pathologically positive. Hydrometra was associated in two adenocarcinomas patients, and hematometra in one patient. Compared with squamous cell carcinomas, more frequent MR findings of endocervical type and barrel shape in cervical adenocarcinomas were statistically significant. Conclusion : Cervical adenocarcinomas had more frequent MR findings of endocervical type and barrel shape, compared with wquamous cell carcinomas. Adenocarcinoma of the uterine cervix may be suspected on MR imaging, when a cervical carcinoma is of barrel shape along the endocervical canal and tends to involve lymth nodes in earlier stages.
Background: To investigate the inhibitory effect and the underlying mechanism of triptolide on cultured human endometrial carcinoma HEC-1B cells and corresponding xenograft. Materials and Methods: For in vitro studies, the inhibition effect of proliferation on HEC-1B cell by triptolide was determined by MTT assay; cell cycle and apoptosis of the triptolide-treated and untreated cells were detected by flow cytometry. For in vivo studies, a xenograft tumor model of human endometrial carcinoma was established using HEC-1B cells, then the tumor-bearing mice were treated with high, medium, and low-dose ($8{\mu}g$, $4{\mu}g$ and $2{\mu}g/day$) triptolide or cisplatin at $40{\mu}g/day$ or normal saline as control. The mice were treated for 10-15 days, during which body weight of the mice and volume of the xenograft were weighted. Then expression of Bcl-2 and vascular endothelial growth factor (VEGF) was analyzed by SABC immunohistochemistry. Results: Cell growth was significantly inhibited by triptolide as observed by an inverted phase contrast microscope; the results of MTT assay indicated that triptolide inhibits HEC-1B cell proliferation in a dose and time-dependent manner; flow cytometry showed that low concentration (5 ng/ml) of triptolide induces cell cycle arrest of HEC-1B cells mainly at S phase, while higher concentration (40 or 80 ng/ml) induced cell cycle arrest of HEC-1B cells mainly at G2/M phase, and apoptosis of the cells was also induced. High-dose triptolide showed a similar tumor-inhibitory effect as cisplatin (-50%); high-dose triptolide significantly inhibited Bcl-2 and VEGF expression in the xenograft model compared to normal saline control (P<0.05). Conclusions: triptolide inhibits HEC-1B cell growth both in vitro and in mouse xenograft model. Cell cycle of the tumor cells was arrested at S and G2/M phase, and the mechanism may involve induction of tumor cell apoptosis and inhibition of tumor angiogenesis.
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