• Title/Summary/Keyword: Uterine cervix

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Radiotherapy in Small Cell Carcinoma of the Uterine Cervix (자궁경부 소세포암종의 방사선치료)

  • Chung Eun Ji;Lee Yong Hee;Kim Gwi Eon;Suh Chang Ok
    • Radiation Oncology Journal
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    • v.15 no.4
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    • pp.369-377
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    • 1997
  • Purpose : This study was Performed to identify the histopathologic feature by the reevaluation of the Pathologic specimen of the cervical tumors and to evaluate the clinical findings and the treatment results of the patients with small cell carcinoma of the cervix treated by radiotherapy. Materials and Methods : 2890 patients with cervical carcinoma received radiotherapy at the Department of Radiation Oncology. Yonsei Cancer Center, Yonsei University College of Medicine between October 1981 and April 1995. Of the 2890 patients in this data base, sixty were found to have small cell carcinomas $(2.08\%)$. Among them thirty six patients were transferred from other hospitals. the biopsy specimens of those Patients were not available. So we could review the slides of the other twenty four patients who were diagnosed at our hospital. Twenty four patients with small cell carcinoma of the cervix were analyzed retrospectively based on the assessment of H & E staining and other four immunohistochemical stains for neuroendocrine differentiation (neuron specific enolase, chromogranin. synaptophysin and Grimelius stain). And we also evaluate the Patients and tumor characteristics. response to radiation. patterns of failures, 5 year overall and disease free survival rates. Results : Thirteen tumors were neuroendocrine carcinomas(13/24 = $54.2\%$) and eleven tumors were squamous carcinomas, small cell type (11/24 = $47.8\%$) based on the assessment of H & E staining and other four neuroendocrine marker studies. So we classified the Patients two groups as neuroendocrine carcinoma and small cell type of squamous carcinoma, Among the 13 neuroendocrine carcinomas, five were well to moderately differentiated tumors and the other eight were Poorly differentiated or undifferentiated ones. The median age was 54 years old (range 23-79 years). Eight Patients had FIGO stage IB disease, 12 had stage 11, 3 had stage III and one had stage IV disease, Pelvic lymph node metastases were found in five Patients $(20.8\%)$. three of them were diagnosed by surgical histologic examination and the other two were diagnosed by CT scan. There was no difference between two histopathologic groups in terms of patients and tumor characteristics. response to radiation. 5 year overall and disease free survival rates. However the distant metastases rate was higher in neuroendocrine carcinoma Patients (6/13:$46.2\%$) than in small cell type of squamous carcinoma Patients (2/11:$18.2\%$), but there was no statistically significant difference because of the small number of patients (P>0.05). Conclusion : More than half of the small cell carcinoma of the cervix patients were neuroendocrine carcinoma (13/24 : $54.1\%$) by reevaluation of the biopsy specimen of the cervical tumors. The tendency of distant metastases of the neurolndocrine carcinoma was greater than those of the small cell type of squamous carcinoma $(46.2\%\;vs.\;18.2\%)$. But there were no differences in the patients and tumor characteristics and other clinical treatment results in both groups. These data suggest that radical local treatment such as radiotherapy or radical surgery combined with combination systemic cytotoxic chemotherapy might provide these patients with the best chance for cure.

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Results of Radiation Alone Versus Neoadjuvant Chemotherapy and Radiation in Locally Advanced Stage of Uterine Cervical Cancer (진행된 자궁경부암에서 방사선치료 단독과 항암 화학요법 및 방사선치료 병용요법의 결과)

  • Kim, Jin-Hee;Choi, Tae-Jin;Kim, Ok-Bae
    • Radiation Oncology Journal
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    • v.15 no.3
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    • pp.255-262
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    • 1997
  • Purpose : This is retrospective study to compare the results of radiation therapy alone and neoadjuvant chemotherapy and radiation in advanced stage of uterine cervical cancer. Materials and Methods : Seventy-six Patients who were treated with definitive radiation therapy for locally advanced cervical cacinoma between June 1988 and December 1993 at the department of radiation oncology, Keimyung University Dong-san Hospital. Thirty six patients were treated with radiation therapy alone and forty patients were treated with cisplatin based neoadjuvant chemotherapy and radiation therapy. According to FIGO staging system. there were 48 patients in stage IIb, 3 patients in stage IIIa, 23 patients in stage lIIb and two patients in stage IVa with median age of 53 years old. Follow-up periods ranged from 7 to 95 months with median 58 months. Results : Complete response (CR) rate were $86.1\%$ in radiation alone group and $80\%$ in chemoradiation group. There was no statistical difference in CR rate between the two groups. Overall five-year survival rate was $67.3\%$. According to stage, overall five-rear survival rates were $74\%$ in stage IIb, $66.7\%$ in stage IIIa, $49.8\%$ in stage IIb, $50\%$ in stage IVa. According to treatment modality overall five year survival rates were $74.1\%$ in radiation alone and $61.4\%$ in chemoradiation group (P=0.4) Five rear local failure free survival rates were $71.5\%$ in radiation alone group and $60\%$ in chemoradiation group (P=0.17). Five year distant metastasis free survival rates were $80.7\%$ in radiation aione group and $89.9\%$ in chemoradiation group (P=0.42). Bone marrow suppression (more than noted in 3 cases of radiaion alone group and 1 case of chemoradiation group. Grade II retal complication was noted in 5 patients of radiation group and 4 patients In chemoradiation group. Bowel obstruction treated with conservative treatment (1 patient) and bowel perforation treated with surgery (1 patient) were noted in radiation alone group. There was no statistical difference in complication between two groups. Conclusion : There was no statistical difference in survival, failure and complication between neoadjuvant chemotherapy and radiation versus radiation alone in locally advanced uterine cervical carcinoma.

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A New Device for Intrauterine Artificial Insemination in the Dog

  • Kong, I.K.;Yu, D.J.;Jeong, S.R.;Oh, I.S.;Yang, C.J.;Cho, S.G.;Bae, I.H.;Oh, D.H.;Kim, H.R.;Cho, S.K.;Park, C.S.
    • Asian-Australasian Journal of Animal Sciences
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    • v.16 no.2
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    • pp.180-184
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    • 2003
  • The intrauterine inseminator (IUI) was developed to provide the method of depositing dog semen into the uterine body instead of the vagina. The IUI consists of a vaginal endoscope, a balloon sheath, and injection catheter. When the endoscope is inserted into the vagina and the balloon expanded with air, the cervical os becomes visible so a injection catheter can be inserted through the cervix for deposition of the frozen-thawed semen. The efficacy of the IUI device was compared to intra-vaginal artificial insemination using semen that had been collected and frozen from pooled sperm-rich fraction of ejaculates collected from two Jindo dog donors. Aliquots of semen were extended with a Tris-egg yolk diluent, centrifuged, the seminal plasma removed, the pellet resuspended with the same diluent, and cooled to $5^{\circ}C$ over a 2 h period. A Tris-egg yolk-glycerol extender was added at $5^{\circ}C$; after 1 h, semen was loaded into 0.5 ml straws, and straws were frozen in LN vapor for 5 min, and immersed in LN for storage. The final sperm concentration for freezing was approximately $100{\times}10^{6}cells/ml$. The straws were thawed at $70^{\circ}C$ for precisely 6 sec, 1.5 ml Tris-egg yolk buffer at $38^{\circ}C$ added, and the 2 ml of thawed semen was used for a single insemination using the IUI device. Each bitch was inseminated at optimal insemination point, which was estimated by vaginal epithelial cells staining and progesterone concentration analysis. Use of the IUI device resulted in 21 of 26 females giving birth to 89 pups ($4.2{\pm}1.6$ pups per litter), while intra-vaginal AI resulted in 6 of 15 females whelping a total of 17 pups ($2.8{\pm}1.2$ pups per litter). We believe the IUI device is easier to use than previously described devices used for intrauterine insemination. In our experience the expansion of the balloon has a calming effect on the bitch that aids the inseminator. These results indicate that the IUI device was able to provide high fertility with 50 million frozen sperm per insemination and two inseminations.

Burden of disease of major cancers assessment using years of lives with disability in Korea (장애에 따른 상실건강년수를 활용한 우리 나라 주요 암질환의 질병부담에 관한 연구)

  • Yoon, Seok-Jun;Chang, Hye-Jung;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.4 s.63
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    • pp.801-813
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    • 1998
  • This study was carried out for the burden of disease of major cancers assessment using years of lives with disability in Korea. With the years of lives with disability, this indicator was applied in order to estimate burden of major cancer disease. For this work, We also estimated incidence rate, remission rater case fatality rate, average age of onset, expected duration with disability in each cancer disease. As sources of information, national health insurance data and national mortality registration data were analyzed. The results of the study are as follows; The top five causes of the burden of major cancer disease are evaluated as stomach cancer, liver cancer, colon and rectum cancer, esophageal cancer, lung cancer in male. The top five causes of the burden of major cancer disease are evaluated as stomach cancer, esophageal cancer, liver cancer, uterine cervix cancer ovarian cancer in female. The process of evaluating the burden disease of major cancers in Korea has not finished with this paper. This study should be seen as the first in a series in Korea. It is necessary to analyse with more accuracy the assumptions behind the methodology.

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Mast Cells are Responsible for Expression of α-Smooth Muscle Actin in Stromal Cells of the Uterine Cervix during Epithelial Neoplastic Changes (자궁경부상피의 악성변화에서 비만세포가 간질세포의 α-Smooth Muscle Actin 발현에 미치는 영향)

  • Jekal, Seung-Joo;Choi, Young-Ja;Lee, Kwang-Joo;Roh, Jong-Sup
    • Korean Journal of Clinical Laboratory Science
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    • v.39 no.3
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    • pp.210-216
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    • 2007
  • There is increasing evidence that stromal reaction in cancer has an important diagnostic and prognostic significance. The aim of our study is to analyze the relation between the increase in mast cell number and the expression CD34 and alpha-smooth muscle actin (${\alpha}$-SMA) in the stroma of cervical intraepithelial neoplasia (CIN) and squamous cell carcinoma (SCC). We investigated a total of 29 CIN (1,2,3) and 21 SCC (microinvasive and invasive) specimens and compared the distribution of $CD34^+$ stromal cells, ${\alpha}-SMA^+$ cells, transforming growth factor-${\beta}1$ $(TGF-{\beta}1)^+$ cells, and the density of mast cells using immunohistochemistry with antibodies against CD34, ${\alpha}$-SMA, TGF-${\beta}1$, and c-Kit (CD117) respectively. Computerized image analysis was to evaluate the positive area (%) and density of the respective immunoreactive cells. In CIN $CD34^+$ cells were abundant in the stroma but no ${\alpha}-SMA^+$ cells were identified except the wall of blood vessels. $CD34^+$ cells were progressively decreased along the continuum from CIN 2 to microinvasive SCC and not observed in the stroma of invasive SCC. Whereas ${\alpha}-SMA^+$ cells were only observed in the stroma of microinvasive and invasive SCC. We found more intense TGF-${\beta}1$ expression in the increased mast cells in the stroma of invasive SCCs than that in the stroma of CIN. These results indicate that disappearance of $CD34^+$ stromal cells and appearance of ${\alpha}-SMA^+$ cells are associated with the stromal change of CIN to SCC and the transformation of $CD34^+$ stromal cells into ${\alpha}-SMA^+$ cells is mediated by TGF-${\beta}1$ secretions in the stromal mast cell of SCC.

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Effect of time and depth of insemination on fertility of Bharat Merino sheep inseminated trans-cervical with frozen-thawed semen

  • Kumar, Davendra;Naqvi, Syed Mohammed Khursheed
    • Journal of Animal Science and Technology
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    • v.56 no.3
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    • pp.8.1-8.6
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    • 2014
  • Background: Artificial insemination (AI) can serve as a powerful tool to the sheep owners for making rapid genetic progress of their flock. The AI in sheep is mostly performed using fresh semen with two reasons i) lambing rate following trans-cervical AI with frozen semen is limited by the inability of frozen-thawed sperm to transit the cervix and ii) the need of circumventing the cervical barrier through laparoscope aided intrauterine AI. Therefore, AI with frozen-thawed semen is not as widespread in sheep as it is in other domestic species. However, to get maximum benefits through the use of AI, frozen-thawed semen is a prerequisite because instead of high fertility, the short shelf life of fresh semen coupled with a limitation on the number of insemination doses achievable per unit time restricts the widespread use of individual sires. Therefore, in order to enhance lambing rate, a total of 240 trans-cervical artificial inseminations with frozen-thawed semen were performed in Bharat Merino ewes during autumn season either once in the evening (G-I, 10 h after onset of estrus, n = 100) or twice (G-II, 14 h and 22 h after onset of estrus, n = 140) i.e. once in the morning and again in the evening. Results: The pregnancy rate (proportion of pregnant ewes confirmed by ultrasonography at day 40) and lambing rate (proportion of ewes lambed) were higher in G-II as compared to G-I (26.4 vs 20% and 19.3 vs 10%, respectively). The difference in lambing rates was statistically (P < 0.05) significant. The depth of insemination within cervico-uterine tract had no significant effect on pregnancy and lambing rates. Conclusions: The results indicate that lambing rate in sheep following TCAI with frozen-thawed semen was significantly influenced by time of inseminations. Two inseminations after 14 and 22 h of onset of estrus enhanced the lambing rates of Bharat Merino sheep as compare to single insemination after 10 h of onset of estrus. The TCAI technique with frozen-thawed ram semen is promising and may serve as a valuable tool for genetic improvement of sheep breeds. Research efforts are going on worldwide to overcome the poor fertility following TCAI with frozen-thawed semen.

Effectiveness of a Custom-made Multi Purpose Brachytherapy Phantom (자체 제작한 근접방사선치료용 다목적 팬텀의 유용성 평가)

  • Jang, In-Gi;Lee, Jin-Joung;Kim, Wan-Sun
    • The Journal of Korean Society for Radiation Therapy
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    • v.18 no.2
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    • pp.119-125
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    • 2006
  • Purpose: To measure the dose for dose optimization at the reference point (A, B) and the critical organ with multi Purpose brachytherapy phantom (MPBP). For this wort the MPBP was custom made, and designed to reconstruct the treatment applicator using multi function applicator (MFA) in the same way as the treatment of patient. Materials and Methods: Dose measurements were made at the reference points (A, B) and the bladder with thermoluminescence dosimeter (TLD) for four patients with tandem and ovoid of uterine cervix cancer using the phantom. In Phantom, Total 20 times of the measurements were made with 5 times a patient. Results: The results of TLD measurements in MPBP phantom showed the relative error ranging from -3.2% to 3.8% at A point, and -1.4% to 4% at B point and 1.3% to 7.15% at the bladder of reference point. Conclusion: The reproducibility of dose measurement under the same condition as the treatment could be achieved using the custom-made MFA in phantom and the dose at the reference point (A, B) and bladder could be analyzed accurately. The measured dose acquired in MPBP can apply for the dose optimization.

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Production of Pups Following Artificial Insemination by Canine Intrauterine Inseminator (개 자궁내 인공수정기에 의한 인공수정 후 산자생산)

  • 공일근;조성균;임용택;이상인;위성하
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.375-380
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    • 1999
  • This study was conducted to develop an intrauterine inseminator (IUI) to deposit of frozen semen into uterus and to evaluate the results obtained after artificial insemination by IUI. Two Japanese spitzs (2 to 4 years of age) were used as semen donors. Semen was collected by manual masturbation into sterile glass collection tubes and separated into 3 fractions with only the sperm-rich fractions retained for further examination. Sperm motility >70%, sperm concentration of 200 to $400{\times}10^6 cells/ml$$\times$g for 5 min and poured out the suspended solution, and then diluted with 2 ml Tris-buffer which was consisted of 2.4 g Tris, 1.4 g citric acid, 0.8 g glucose, 0.1 $\mu\textrm{g}$/ml streptomycin, 100 IU/ml penicillin, 20 ml egg yolk to 100 ml mili-Q water (Ext I) or supplemented with 8 ml glycerol and 1 ml Equex STM paste to 100 rnl (Ext II). The diluted semen was cooled to 5$^{\circ}C$ in cold room, where the temperature in the sample reached 5$^{\circ}C$. Two h after beginning the cooling procedure, 2 ml of Ext II, also at 5$^{\circ}C$, was added and mixed by gently reversing the tubes several times during 1 h. The final sperm concentration for freezing was approximately $50{\times}10^6 cells/ml$. After equilibration, the semen was loaded into 0.5 ml straw and frozen on the liquid nitrogen vapour in styrofoam box. The straws were thawed at 7$0^{\circ}C$ for precisely 6 sec. After thawing of each straw, the frozen semen can survived over 50% motility. All the females were inseminated twice with 1 ml of $25{\times}10^6 cells/ml$

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Prognosis and Surgical Treatment of the Urethra Embedding Leiomyosarcoma in a Dog (개에서 요도를 포매한 평활근육종의 수술적 처치 및 예후)

  • Kim, Ji-Hyun;Lee, Jun-Am;Kim, Ill-Hwa;Jang, Dong-Woo;Kang, Hyun-Gu
    • Journal of Veterinary Clinics
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    • v.31 no.4
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    • pp.307-312
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    • 2014
  • A 16-year-old female Shih-Tzu, weighing 5 kg, presented with clinical symptoms of abdominal distension and urinary and fecal incontinence. Abdominal palpation detected a large mass. According to the radiographic findings, the bladder had been moved to the umbilicus by the mass and a large abdominal mass was confirmed in the lower abdominal area. Ultrasonography indentified a large heterogeneous mass with heterogeneous parenchyma and a focal anechoic area in the lower abdominal area. The complete blood count abnormalities suggested thrombocytosis and mild neutrophilia, and the serum chemistry indicated an elevated alkaline phosphatase value. During laparotomy, a firm mass that measured $10.5{\times}9.6cm$ was found between the uterine cervix and urinary bladder. The urethra was embedded in the mass. A diagnosis of leiomyosarcoma was established based on histopathology and histochemistry. One week after surgery, urinary retention symptoms that did not appear to be related to mechanical obstruction presented suddenly, but they did not respond to several drug treatments, thus long-term conservative therapy was adopted. The urinary symptoms disappeared on day 27 and the patient started to void large quantities of urine in a smooth and frequent manner. This case report describes the serial changes in the patient's status and the response after surgical remove of the urethra embedding leiomyosarcoma.

Local Cervical Immunity in Women with Low-grade Squamous Intraepithelial Lesions and Immune Responses After Abrasion

  • Ekalaksananan, Tipaya;Malat, Praphatson;Pientong, Chamsai;Kongyingyoes, Bunkerd;Chumworathayi, Bandit;Kleebkaow, Pilaiwan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4197-4201
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    • 2014
  • Minor trauma to the uterine cervix is supposed to induce local immunity to prevent cervical lesions caused by human papillomavirus (HPV) infection. This study aimed to investigate the local cervical immunity in women with low grade squamous intraepithelial lesion (LSIL) and effects of abrasion after cryosurgery or Pap smear. One hundred women with LSIL and known results of HPV detection were recruited. HPV positive women were randomly divided according to abrasion into cryotherapy and Pap smear observation groups. Cervical tissues and cervico-vaginal lavage (CVL) were collected at 6 and 12 months after allocation. The levels of cytokines at first recruitment were compared with cytokine levels at 6 months after abrasions. The mRNA of IFN-${\gamma}$, TNF-${\alpha}$ and IL-10 in cervical tissues and these cytokines secreted in CVL were determined using real time PCR and ELISA, respectively. Anti-HPV16 IgG and IgA antibodies in CVL were assessed by western blotting. At first recruitment of women with LSIL (100 cases), IL-10 mRNA and cytokine in HPV positive group (60 cases) was significantly higher than negative group (40 cases). IFN-${\gamma}$ and TNF-${\alpha}$ mRNA level in both groups were comparable but their secretions in CVL were significantly increased in HPV negative group. After abrasion for 6 months in HPV-positive women, all mRNA and secreted cytokines were changed, but no significant difference was observed between cryotherapy and observation groups. When individuals were compared between first recruitment and after abrasion for 6 months, IFN-${\gamma}$ mRNA and anti-HPV16 L1 IgA antibodies were significantly increased in the cryotherapy group. The results suggest that modulation of local cervical immunities by abrasion might promote different effects in clearance of HPV-related cytological abnormalities.