• Title/Summary/Keyword: Uterine Cervix

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Comparison Study of Dose Rate and Physical Parameters in Low and High Dose Rate Intracavitary Radiation Systems for Carcinoma of the Uterne Cervix. (자궁경부암 강내 방사선조사에 있어서 고 및 저 선량율방법에 의한 선량율 비교 고찰)

  • Yang, Chil-Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.1 no.1
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    • pp.70-78
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    • 1985
  • The intrauterine irradiation is essential to achieve adequate tumor dose to centeral tumor mass in radio therapy for uterine malignancy. The complications of pelvic organ are known to be directly related to radiation dose and physical parameters. The comparison study of currently using 2 systems was undertaken. The simulation films and medical records of 135 patients who was treated with intrauterine irradiation at one of general hospitals in Busan and Seoul between Jan. 1983 and June 1983, were critically analized and physical parameters of low dose rate system and remote controlled high dose rate system were measured. The physical parameters include distances between lateral walls of vaginal fornices, longitudinal and lateral angles of tandem to the body axis, the distance from the external os of uterine cervix to the central axis of ovoids, the radiation dose ratio to rectum and bladder to reference point A. Followings were summary of study results: 1. In distances between lateral walls of vaginal fornices the low dose rate system showed wide distribution and relatively larger distances. In low dose rate system 5.0-5.9 cm was $55.89\%$ 6.0-6.9 cm: $23.53\%$, 4.0-4.9cm: $10.29\%$, 3.0-3.9cm: $10.29\%$, and in high dose rate system 5.0-5.9cm was $80.59\%$, 4.0-4.9cm: $17.91\%$, $6.0\~6.9\;cm:\;1.5\%$. 2. In lateral angulation of tandem to body axis, the low does system revealed mid position (the position along body axis) $64.7\%$, Lt. deviation $19.13\%$ and Rt. deviation $16.17\%$. However the high dose rate system revealed mid position $49.26\%$ Lt. deviation $40.29\%$ and Rt. deviation $10.45\%$. 3. In longitudinal angulation of tandem to body axis the mid position was $11.77\%$ and anterior angulation $88.23\%$ in low dose rate system but in high dose rate system the mid position was $1.56\%$ and anterior angulation $98.44\%$. 4. Down ward displacement of ovoids below external os was only $2.94\%$ in low dose rate system and $67.69\%$ in high dose rate system. 5. The radiation dose ration to rectum to reference point A was $102.70\%$ in high dose rate system and $70.09\%$ in low dose rate system. The dose ratio to bladder to reference point A was $78.14\%$ in high dose rate system and $75.32\%$ in low dose rate system.

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Radiotherapy Result of the Carcinoma of Uterine Cervix (자궁경부암의 방사선치료성적)

  • Park, Charn-Il;Ha, Sung-Whan;Kang, Soon-Beom;Lee, Hyo-Pyo;Shin, Myon-Woo
    • Radiation Oncology Journal
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    • v.2 no.1
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    • pp.107-113
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    • 1984
  • One hundred sixty one patients with the carcinoma of uterine cervix received curative radiotherapy at the Department of Therapeutic Radiology, Seoul National University Hospital between December, 1979 and December, 1982. According to FIGO classification; stage $I_a 1(0.6\%)\;1_b\;8(5.0\%),\;II_a\;31(19.3\%),\;II_b\;66(41.0\%),\;III_a\;3(1.8\;%),\;III_b\;46(28.6\%)\;and\;IV_a\;6(3.7\;%)$. The proportion of early stage cancer is too small because most of them treated by surgery. External beam whole pelvic irradiation was done first with 10MV x-ray or Co-60 gamma ray upto 4,000 or 5,000 rad for early and advanced cases, followed by one or two courses of intracavitary radiation using Fletcher-Suit Applicator loading c Cs-137. Supplementary external radiation to pelvic side wall to bring dose to 6,000 or 6,500 rads, if there is parametrial involvement or positive pelvic lymph node. Of the 161 Patients, 49 Patients were lost to follow-up but only 22 patients were lost in disease free state. And so, 86.3 percent of the patients were followed to time of recurrence or to date. The results are as follows ; 1. Locoregional control rates according to stage is: stage I $100\%,\;II_a\;90.3\;%,\;II_b\;75.8\%,\;III_a\;66.7\%,\;III_b\;58.7\%\;and\;IV_a\;16.7\%$, respectively. 2. Persistent or recurrent disease were localized in pelvic cavity in 32 of 50 patients and 6 had distant metastasis only. 3. Rectal bleeding was the most common complication and appeared mostly between 6 and 24 months after radiotherapy. Most of them had transient minor bleeding and only 2 patients needed transfusion and 1 patient needed colostomy due to rectovaginal fistula. 4. The 3 year disease free survival rate is: stage I $100\%,\;II_a\;78.0\%,\;II_b\;60.6\%,\;III_a\;66.7\;III_b\;46.3\%\;and\;IN_a\;16.7\%$, respectively.

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Expression of p53 and Ki-67 in Cervical Dysplasia with Human Papilloma Virus Infection or Non-infection (인유두종 바이러스의 감염 또는 감염되지 않은 자궁 경부 이형성증에서 p53 및 Ki-67의 발현)

  • Choi, Sook-Kyung;Kim, Tai Jeon;Hong, Seung Bok;Lee, Hun Taeck
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.2
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    • pp.178-184
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    • 2004
  • This research focuses on the overall evaluation of tumor protein (p53) and cell growth marker (Ki-67) in their functions as carcinogenic factors in both a HPV-infected group and in a HPV-noninfected group with the precancerous dysplasia of uterine cervix. Histological grades were determined by the H&E staining and the expression level of p53 and Ki-67 were tested by the immunohistochemistry method. The results were as follows. Among the total of 66 cases, p53 (+) was observed in 19 cases (29.0%) from the mild grade group, 22 cases (33.0%) from the moderate grade group, and 19 cases (29.0%) from the severe grade group. The values correlate with the increase of dysplasia intensity in HPV-noninfected group and showed significant correlation (p<0.05), but there were no significant difference from the HPV-infected group. Among a total of 66 cases, the mitotic index of Ki-67 (+) were observed in 19 cases (29.0%) from the mild grade group, 22 cases (33.0%) from the moderate grade group, and 19 cases (29.0%) from the severe grade group. The values were significantly different against dysplasia intensity (p<0.05), but showed no significant difference from HPV infection. After cross comparing the statistical parameters of p53 and ki-67 in their significance, p53 was shown to be statistically significant with Ki-67 while there was no statistically significant difference with Ki-67 (p<0.05). Taken together, tumor protein (p53) and an index of Ki-67 observed in cervical dysplasia and in HPV related dysplasia of cervix uterine did not have any notable significance with HPV infection. The incidence rate of p53, however, had some significant correlation with dysplasia while Ki-67 had no particular statistical significance. As a result, p53 and Ki-67 can be considered as effective diagnostic markers in predicting the disease progression of dysplasia to cervical cancer.

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Application of Modified Mupit for the Recurrent Vulva Cancer in Brachytherapy

  • Kim, Jong-Sik;Jung, Chun-Young;Oh, Dong-Gyoon;Song, Ki-Won;Park, Young-Hwan
    • 대한방사선치료학회:학술대회논문집
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    • 2005.06a
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    • pp.23-26
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    • 2005
  • Introduction: To evaluate whether modified MUPIT applicator can effectively eradicate recurrent tumor in uterine cervix cancer and reduce rectal complication after complete radiation treatment. Methods and Materials: 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 performed 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-Ir HDR) after calculated computer planning by orthogonal film. The daily dose was 600cGy and the total dose was delivered 3000cGy in tumor volume by BID. Rectal dose was measured by TLD at 5 points so that evaluated the risk of rectal complication. Result: 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 34.1cGy, 57.1cGy, 103.8cGy, 162.7cGy, 165.7cGy at each points, especially the rectal dose including previous EBRT and ICR was 34.1cGy, 57.1cGy Conclusion: Patients with locally recurrent tumor in uterine cervix cancer treated with modified MIUPIT 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

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Expression of P-glycoprotein is Positively Correlated with p53 in Human Papilloma Virus Induced Squamous Intraepithelial Lesions of Uterine Cervix: Poor Prognosis Association

  • Singh, Madhulika;Singh, Uma;Mathur, Neeraj;Shukla, Yogeshwer
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.12
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    • pp.6039-6045
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    • 2012
  • This study was conducted to assess the predictive value of p-glycoprotein (p-gp) and p53 immunoexpression in human papillomavirus (HPV) infected cases of cervical dysplasia. Expression of both p-gp and p53 proteins was detected in cervical smears from 177 squamous intraepithelial lesions (SIL) cases along with 183 "atypical squamous cells of unknown significance" (ASCUS) and 150 normal cases. HPV 16 and 18 infection was detected by polymerase chain reaction using type-specific primers for HPV sub-types. There were no significant detectable p53 and p-gp expression in the normal cervix smears (p>0.05). In the ASCUS group 10 cases were positive for both p53 and p-gp immunoreactivity. In cervical dysplasia cases, p53 was positive in 86 (48.58%) while p-gp was positive in 93 (52.54%) and the two markers showed a highly significant correlation (r=0.92, p<0.001). Expression of p53 and p-gp was associated with grade of SIL (p<0.001). A positive correlation between the presence of HPV and expression of proteins p53 and p-gp in smears of patients with cervical lesions was also noted (p<0.001). Thus, p53 and p-gp immunostaining in cervical smears may act as an auxiliary biomarker for detection of HPV-associated cervical lesions. Additionally, a significant positive correlation between ascending grades of SIL and labeling indices of markers suggests that p53 and p-gp can be used as an adjunct to cytomorphological interpretation of conventional cervical Pap smears.

PREGNANCY RATES IN PHILIPPINE SWAMP BUFFALOES(CARABAOS) FOLLOWING CLITORAL STIMULATION DURING TIMED INSEMINATIONS

  • Capitan, S.S.;Momongan, V.G.;Obsioma, A.R.;del Barrio, A.N.
    • Asian-Australasian Journal of Animal Sciences
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    • v.5 no.2
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    • pp.275-278
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    • 1992
  • One hundred sixty three (163) animals were used in $2{\times}2$ and $3{\times}2$ factorial experiment in randomized complete block design (RCBD) to determine the effect of clitoral stimulation during timed inseminations on the fertility of Philippine swamp buffaloes (carabaos). There were 3 separate trials conducted with two treatment groups per trial : control and with 30 second clitoral stimulation after each insemination. Parity, tone of uterus and site of semen deposition were also used as criteria in subdividing the main groups. The pregnancy rates of animals that received clitoral stimulation were significantly (p<0.05 or p<0.01) higher than those of control for both caraheifers (52.98 vs 31.41%) and caracows (52.68 vs 27.07%) ; under all uterine conditions : tone 1 (53.33 vs 31.75%), tone 2 (35.83 vs 22.82%) and tone 3 (75.65 vs 42.44%) ; and in both site of semen placement, cervix (43.99 vs 22.85%) and uterus (60.92% vs 37.81%). Fertility was also significantly (p<0.05) higher when semen was deposited in the uterus (49.37%) than in the cervix (33.42%). Interaction effect was insignificant. Clitoral stimulation should be utilized as a routine procedure following artificial insemination in carabaos.

A Study on Automatic Detection of Uterine' Cervical Pap- Smears by Image Processing (영상처리를 이용한 자궁경부 세포진의 자동탐색 방법에 관한 연구)

  • Un, Sung-Kyung;Park, Chan-Mo;Park, Hwa-Choon;Yoon, So-Young;Cho, Min-Sun;Cho, Soo-Yeon;Kim, Sung-Sook
    • The Korean Journal of Cytopathology
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    • v.5 no.1
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    • pp.15-22
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    • 1994
  • Cancer of the cervix is the most common malignancy in women in developing countries and the second most common cancer in women throughout the world with approximately 500,000 new cases each year. Prevention of this large number of premature deaths among women is, therefore, a goal worthy of urgent and serious consideration. Due to its high diagnostic disagreement among pathologists and large quantity of specimens, it is necessary to develop an automatic screening system measuring morphologic and densitometric features of the samples. Many research works have been published but most of them used Feulgen stained specimens which are not a usual staining method used in clinics. In this thesis, an automatic cancerous nucleus detection method essential to a screening system with papanicolaou stained specimens called Pap-smear is proposed which employs image processing techniques. It uses edge information to segment objects and morphologic as well as densitometric information to distinguish cancerous nuclei from dirts or normal nuclei. It has produced useful results in our study.

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Clinical Characteristics and Treatment Results of Neuroendocrine Carcinoma of Uterine Cervix (자궁경부 신경내분비암의 임상적 특징과 치료 결과)

  • Kim, Ok-Bae;Kim, Jin-Hee;Cha, Soon-Do;Choi, Tae-Jin;Ye, Ji-Won
    • Radiation Oncology Journal
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    • v.22 no.2
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    • pp.124-129
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    • 2004
  • Purpose : To evaluate the clinical findings, prognosis and treatment strategy of patients with neuroendocrine carcinoma of cervix. Materials and Methods: Thirteen patients with neuroendocrine carcinoma of cervix were included in this study, as confirmed histologically and immunohistochemically at the Dongsan Medical Center, Keimyung University, between May 1944 and October 2001. The mean age of patients was 56 years with a range of 32 to 78 years of age. According to the FIGO staging system, there were 5 patients with stage IB carcinoma, 5 patients with IIA, and 3 patients with stage IIB. Four patients underwent radical hysterectomy with pelvic lymphadenectomy, 3 of these patients also received postoperative radiotherapy, and one patient underwent extrafascial hysterectomy after radiotherapy. Primary radiotherapy was done in 9 patients, and 3 were irradiated postoperatively. Nine patients received chemotherapy, 7 received neoadjuvant and 2 received concurrent chemoradiotherapy. The radical purpose of radiotherapy consisted of external irradiation to the whole pelvis (4,500 $\~$5,400 cGy) and intracavitary irradiation (3,000 $\~$ 3,500 cGy). Results : The mean follow up duration was 36 months with a range of 3 to 104 months. The overall 5-year survival rate was 61.5$\%$ and the 5-year survival rates for stage IB, IIA, IIB were 60.0$\%$, 60.0$\%$, and 66.7$\%$ respectively (p=0.99). Eight patients are still alive without disease, and all of the 5 patients with recurrence are dead due to distant metastasis. Conclusion : Neuroendocrine carcinoma of cervix is highly aggressive, with early lymphatic dissemination and a high rate of distant recurrence. Therefore, an aggressive therapeutic strategy Is required to obtain pelvic and distant disease control. Multimodal therapy should be considered at the time of Initial diagnosis.

Visualization of unstructured personal narratives of perterm birth using text network analysis (텍스트 네트워크 분석을 이용한 조산 경험 이야기의 시각화)

  • Kim, Jeung-Im
    • Women's Health Nursing
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    • v.26 no.3
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    • pp.205-212
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    • 2020
  • Purpose: This study aimed to identify the components of preterm birth (PTB) through women's personal narratives and to visualize clinical symptom expressions (CSEs). Methods: The participants were 11 women who gave birth before 37 weeks of gestational age. Personal narratives were collected by interactive unstructured storytelling via individual interviews, from August 8 to December 4, 2019 after receiving approval of the Institutional Review Board. The textual data were converted to PDF and analyzed using the MAXQDA program (VERBI Software). Results: The participants' mean age was 34.6 (±2.98) years, and five participants had a spontaneous vaginal birth. The following nine components of PTB were identified: obstetric condition, emotional condition, physical condition, medical condition, hospital environment, life-related stress, pregnancy-related stress, spousal support, and informational support. The top three codes were preterm labor, personal characteristics, and premature rupture of membrane, and the codes found for more than half of the participants were short cervix, fear of PTB, concern about fetal well-being, sleep difficulty, insufficient spousal and informational support, and physical difficulties. The top six CSEs were stress, hydramnios, false labor, concern about fetal wellbeing, true labor pain, and uterine contraction. "Stress" was ranked first in terms of frequency and "uterine contraction" had individual attributes. Conclusion: The text network analysis of narratives from women who gave birth preterm yielded nine PTB components and six CSEs. These nine components should be included for developing a reliable and valid scale for PTB risk and stress. The CSEs can be applied for assessing preterm labor, as well as considered as strategies for students in women's health nursing practicum.

Laparoscopic Ovariohysterectomy in Female Dogs (복강경을 이용한 암캐의 난소자궁절제술)

  • Kim, Young-Ki;Lee, Scott-S.;Park, Se-Jin;Lee, Seung-Yong;Lee, Hee-Chun;Chang, Hong-Hee;Lee, Hyo-Jong;Yeon, Seong-Chan
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.149-153
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    • 2011
  • In this report, laparoscopic ovariohysterectomy (LOHE) was performed on two, healthy, intact female dogs. Three ports, umbilical port for placing the laparoscope and the left and right paramedian instrument ports were placed into the abdominal cavity. First, in order to isolate the right ovary, the vascular pedicle was coagulated by activating the universal bipolar forceps. Then, the pedicle and suspensory ligament were transected by the bipolar electrocauterization scissors. In the same manner, the left ovary was isolated. The uterine body and the uterine arteries were coagulated bilaterally and transected just rostral to the cervix. The isolated ovaries and uterus were exteriorized through the left paramedian instrument port, which was extended by approximately 1 cm to allow for tissue removal. The skin and subcutaneous tissue were closed in a routine manner. Surgical times for LOHE in two dogs were 35, 40 min respectively. Total length of abdominal incision was shorter than 3 cm in two dogs. No clinical complications related to the LOHE were observed during 1.5 years after surgery. The LOHE is an alternative surgical technique that deserves further investigation.