IB IIB Research Articles

Histological predictors of the unfavorable outcome of anorectal melanoma

AIM: to find histological prognostic factors for survival in patients with anorectal melanoma.PATIENTS AND METHODS: single center retrospective study of histological specimens of patients with anorectal melanoma (2005-2023). A revision of histological specimens was carried out, using the following criteria: multifocal growth, maximum tumor size, maximum thickness by Breslow, ulceration, perineural and lymphovascular invasion, as well as depth of invasion. Statistical processing was carried out using the Cox regression.RESULTS: twenty-one patients were included in the study. In all patients, treatment started with surgery: 13 (61.9%) — abdominoperineal excision (APE); 8 (28.1%) — local excision). The sample contained patients with the following initial stages of the process: IB–IIB — 12 (57.1%); III — 9 (42.9%). Nine (42.9%) patients developed local recurrence, and 8 (38.1%) — distant metastases. On univariate analysis, DFS was significantly affected by ulceration RR 0.061 (CI 95.0%; 0.004–0.097, p = 0.048), there was a trend towards the role of neurotropism RR 3.654 (CI 95.0%; 0.934–14.297, p = 0.063) and pigmentation RR 2.485 (CI 95.0%; 0.832–7.424, p = 0.103). In multivariate analysis, none of the criteria had a significant effect on DFS. On OS in univariate analysis was a trend towards an effect of Breslow invasion depth of more than 2 cm HR 1.028 (CI 95.0%; 0.998–1.060, p = 0.070) and depth of tumor invasion HR 2.117 (CI 95.0%; 0.990–4.525, p = 0.053). In multivariate analysis, none of the criteria had a significant effect on OS.CONCLUSION: evaluation of the effectiveness by histological features of skin melanoma showed the potential use of neurotropism, Breslow invasion of more than 2 cm and depth of tumor invasion as factors of unfavorable impact on DFS and OS in ARM. More trials are needed.

An In Vitro Study on the Effects of Hydrogen Peroxide-Based Bleaching Agents on Enamel: Field Emission Scanning Electron Microscopy (FESEM) With Energy Dispersive Spectroscopy (EDS) Evaluation.

Aim and objective The aim of the present in vitro study is to evaluate the morphological and elemental alterations in enamel following bleaching with hydrogen peroxide-based bleaching agents of different concentrations and pH values when exposed to different treatment times. Materials and method Twenty extracted maxillary central incisors were selected for the study. Tooth samples were prepared by sectioning the tooth cervico-incisally into two halves. The teeth were divided into different groups based on the bleaching protocol and bleaching agent applied: Group IA, Group IB, Group IIA, and Group IIB. Group IA received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 10 minutes with light application. Group IB received a 35% hydrogen peroxide-based bleaching agent of pH 6 for 30 minutes with light activation. Group IIA received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 10 minutes with chemical activation. Group IIB received a 40% hydrogen peroxide-based bleaching agent of pH 8.5 for 30 minutes with chemical activation. The morphology of the enamel before and after the application of the bleaching agent was evaluated using field emission scanning electron microscopy. The elemental analysis of enamel between the control and test samples was done with the help of energy dispersive spectroscopy. Results Paired t-test was used to analyze the data obtained from the study. The test samples showed erosive alterations in enamel surface morphology and also a decrease in the concentration of minerals when compared to the corresponding control groups. Conclusions The present study evidences the erosive potential of hydrogen peroxide-based bleaching agents.It can be concluded that bleaching agents containing high concentrations of hydrogen peroxide with acidic pH can cause mineral loss and surface erosion of enamel which is extremely detrimental to the tooth integrity.

Pain perception in 4-6-year-old children following intraoral dental injection with 26 and 31-gauge needles: a randomized controlled trial.

Administering anesthesia in dentistry can be distressing for patients, especially those with dental fear and anxiety. Needle pain during local anesthesia is a common concern in intraoral procedures. This study aimed to compare pain perception in 4-6-year-old children following intraoral dental injections with 26- and 31-gauge needles. Fifty healthy children were divided according to age into Group I (N = 25; 4-5 years) and Group II (N = 25; 5-6 years). Each group was further subdivided according to the needle gauge as follows: Group IA (26 gauge), Group IB (31 gauge), Group IIA (26 gauge), and Group IIB (31 gauge). Using a lottery method, the gauge of the needle to be used at the first visit for local anesthesia administration was selected. Children's reactions to pain were evaluated using a Modified Behavioral Pain Scale. Immediately after administration of local anesthesia, pain perception was evaluated using the Faces pain rating scale. In the subsequent visit, another needle gauge was used to administer local anesthesia, and the previously described evaluations were performed. At the third appointment, the child was shown both syringes and asked to choose one of the syringes they preferred, and the choice was noted. When local anesthesia was administered using a 31-gauge needle, pain perception was similar between the two groups. In group II, the children demonstrated significantly higher arm and leg movements (P = 0.001). However, the difference was significant in group I alone (P < 0.001). Irrespective of age, anesthesia with a 31-gauge needle resulted in significantly lower pain perception than anesthesia with a 26-gauge needle.

Different types of rotator cuff tear morphology do not affect post-repair clinical outcomes in large to massive tears

ObjectivesThe primary aim of this current study is to evaluate the effects of rotator cuff tear morphology on clinical outcomes in large to massive tears, using a modified version of the existing classification system, with specific focus on tear symmetry and use of margin convergence. MethodsPatients who underwent arthroscopic repair of large to massive, full thickness rotator cuff tears were retrospectively analysed. The tear pattern was classified at the time of surgery as Type IA, Type IB, Type IIA, and Type IIB according to tear symmetry and direction of maximum tear diameter, with Type I being symmetrical and Type II being asymmetrical. Type IA (U-shaped) had greater mediolateral (ML) than anteroposterior (AP) diameter while Type IB (crescent shaped) had greater AP than ML diameter. Type IIA tears have an anterior extension towards the rotator interval while IIB tears have a posterior extension into the infraspinatus, similar to AP L-shaped tears established in the literature. Type I tears were typically repaired from medial to lateral while Type II tears were repaired diagonally. All types were repaired using double row technique, with the addition of margin convergence for Types IA and IIB, which had larger tears in the medial and lateral directions. Primary outcome measures were Oxford Shoulder Score, Constant Shoulder Score, University of California at Los Angeles Shoulder Score followed-up at 6, 12, and 24-months as well as retear rates at latest follow-up. ResultsIn total, 109 patients were included in the study with a mean age of 65.5 ​± ​9.4. The prevalence of each tear morphologies from Type IA to IIB was 22.0 ​%, 34.9 ​%, 27.5 ​%, and 15.6 ​%, respectively. All four groups showed statistically significant improvement from pre-operative scores in all 3 outcome measures at 24 months (p ​< ​0.001 for all). No significant difference in primary outcome measures or retear rates was detected between all 4 groups. ConclusionThis study found that different types of cuff tear morphology, despite affecting surgical repair technique, does not influence clinical outcomes post-arthroscopic rotator cuff repair at mid-term follow-up. Level of evidenceRetrospective Cohort study, Level III.

INFLUENCE OF CAPSULE INJUR ON ELBOW RANGE OF MOTION

Articular capsule tear was common in elbow fractures, but the tissue mechanical environment during the wound repairing was not clear. The objective of this study was to evaluate the effects of different injury conditions on the stability of the elbow through animal experiments and finite element (FE) analysis. Different injury locations and repair conditions were considered in animal experiments: Type Ia (unrepaired anterior capsule), type Ib (repaired anterior capsule), type IIa (unrepaired whole capsule) and type IIb (repaired whole capsule). The elbow valgus angle at 0, 2 and 4 weeks was analyzed, and the tissue stress under different injury conditions (without injury, anterior capsule injury and complete capsule injury) was acquired through a FE model including active behavior of muscle. The maximum valgus angles of repaired elbow were smaller than those of unrepaired elbow. In completely capsule injury, the stress of ulna cartilage altered obviously compared with intact condition, and the peak stress occurred at the flexion angle of 60∘. The stress was about 1.63 times that of intact state. The joint capsule was significantly more stressed than other ligaments and played an important role in the flexion of the elbow joint. This study could provide some advice for surgeons.

The prognostic value of the presence of pelvic and/or para-aortic lymph node metastases in cervical cancer patients; the influence of the new FIGO classification (stage IIIC)

IntroductionOne of the major changes in the revised (2018) FIGO-staging system is the addition of stage IIIC to the previously used 2009 system. We evaluated the prognostic value of positive pelvic and/or para-aortic lymph nodes in patients with cervical cancer. MethodsA nationwide retrospective cohort study was performed by analyzing data from the Netherlands Cancer Registry. All patients newly diagnosed with stage IB-IVA between 2005 and 2018 were identified. Three-year, 5-year and 15-year overall survival (OS) rates were estimated with the Kaplan-Meier method. ResultsOf the included 6082 patients, 1740 patients (29%) had pelvic and/or para-aortic lymph node metastases. For patients with FIGO 2009 stage IB-IB1-IIA-IIA1 and stage IB2-IIA2-IIB with pelvic and/or para-aortic lymph node metastases the OS was significantly different (p < 0.001 and p = 0.009), with a 5-year OS of 77% and 67%, compared with 92% and 74% for women without lymph node metastases. For FIGO 2009 stage IIIA-IIIB-IVA with and without lymph node metastases, survival rates are not significantly different (p = 0.064). For FIGO 2018 stage IIIC the 3y-OS, 5y-OS and 15-year OS are 72%, 65% and 59% respectively. Survival rates of IIIC diagnosed based on imaging (IIICr) are significantly impaired compared to stage IIIC diagnosed based on pathology (IIICp) (p < 0.001). ConclusionPatients with FIGO 2009 stage IB–IIB cervical cancer with pelvic and/or para-aortic lymph node metastases have significantly impaired survival compared to patients without metastases. Survival rates of patients with FIGO 2009 stage IIIA–IVA are not affected by lymph node metastases.

Fatty acid amide hydrolase and 9-lipoxygenase modulate cotton seedling growth by ethanolamide oxylipin levels.

Polyunsaturated N-acylethanolamines (NAEs) can be hydrolyzed by fatty acid amide hydrolase (FAAH) or oxidized by lipoxygenase (LOX). In Arabidopsis (Arabidopsis thaliana), the 9-LOX product of linoleoylethanolamide, namely, 9-hydroxy linoleoylethanolamide (9-NAE-HOD), is reported to negatively regulate seedling development during secondary dormancy. In upland cotton (Gossypium hirsutum L.), six putative FAAH genes (from two diverged groups) and six potential 9-LOX genes are present; however, their involvement in 9-NAE-HOD metabolism and its regulation of seedling development remain unexplored. Here, we report that in cotton plants, two specific FAAH isoforms (GhFAAH Ib and GhFAAH IIb) are needed for hydrolysis of certain endogenous NAEs. Virus-induced gene silencing (VIGS) of either or both FAAHs led to reduced seedling growth and this coincided with reduced amidohydrolase activities and elevated quantities of endogenous 9-NAE-HOD. Transcripts of GhLOX21 were consistently elevated in FAAH-silenced tissues, and co-silencing of GhLOX21 and GhFAAH (Ib and/or IIb) led to reversal of seedling growth to normal levels (comparable with no silencing). This was concomitant with reductions in the levels of 9-NAE-HOD, but not of 13-NAE-HOD. Pharmacological experiments corroborated the genetic and biochemical evidence, demonstrating that direct application of 9-NAE-HOD, but not 13-NAE-HOD or their corresponding free fatty acid oxylipins, inhibited the growth of cotton seedlings. Additionally, VIGS of GhLOX21 in cotton lines overexpressing AtFAAH exhibited enhanced growth and no detectable 9-NAE-HOD. Altogether, we conclude that the growth of cotton seedlings involves fine-tuning of 9-NAE-HOD levels via FAAH-mediated hydrolysis and LOX-mediated production, expanding the mechanistic understanding of plant growth modulation by NAE oxylipins to a perennial crop species.

A massive, energetic model for the luminous transitional Type Ib/IIb SN 2020cpg

ABSTRACT Using a combined spectral and light-curve modelling approach, we fit a massive and energetic explosion model to the luminous Type Ib/IIb SN 2020cpg. This model has an ejected mass of ∼(7 ± 2) M⊙ with a final explosion energy of ∼(6 ± 1) × 1051 erg with MNi = 0.27 ± 0.05 M⊙. The early spectra are hot and blue with weak He i lines, and a complicated Hα region suggested to be a multicomponent feature. Modelling the spectra required ∼0.08 M⊙ of H at velocities &amp;gt;11 000 km s−1 and a total He mass of ∼1.0 M⊙ at velocities &amp;gt;9500 km s−1 above CO-rich ejecta. This model has a ratio of kinetic energy and ejected mass of 0.85$_{-0.3}^{+0.5}$ foe M⊙−1. The high luminosity and explosion energy results in a broadened Hα line that is blended with Si ii, C ii, and He i, which led to the initial classification of SN 2020cpg as a Type Ib. We instead classify SN 2020cpg as a bright transitional event between the Type Ib and Type IIb classes. Comparing our model parameters to stellar evolution models, a progenitor mass of 25–30 M⊙, i.e. stripped of most of the hydrogen shell and of some of the helium shell prior to collapse produces a He core of comparable mass. The excess 56Ni production in SN 2020cpg as compared to objects of similar ejected mass may suggest evidence of additional energy sources such as a failed GRB or weak magnetar energy injection, or a smaller remnant mass.

EFFECT OF CHOLECALCIFEROL ON RATE OF MORNING BLOOD PRESSURE RISE IN WOMEN WITH ARTERIAL HYPERTENSION IN PREMENOPAUSAL AND EARLY POSTMENOPAUSAL PERIODS

Objective: To assess effect of cholecalciferol on rate of morning blood pressure (BP) rise in women with arterial hypertension (AH) in premenopausal and early postmenopausal periods. Design and method: We investigated 102 women with AH stage II risk 3 aged 50 (48; 53) years: 50 females in premenopausal period – group I and 52 females in early postmenopausal period – group II. Serum level of 25(OH)D was determined by the immunoenzymatic assay. In groups I and II we identified subgroups with the level of 25(OH)D&lt; 30ng/ml: subgroup IB (n = 25) and subgroup IIB (n = 21) respectively, in which antihypertensive therapy was supplemented with cholecalciferol 2,000 IU/day for 3 months. In subgroups IA (n = 25) and IIA (n = 31) cholecalciferol was not administered. The rate of morning BP rise was calculated by the ratio of the BP rise value to its time using daily monitoring of BP. Results: At baseline the level of 25(OH)D was lower (p &lt; 0,05) in subgroups IB (19,3 ± 8,5ng/ml) and IIB (18,2 ± 9,5ng/ml) than in the comparable subgroups IA (26,7 ± 11,5ng/ml) and IIA (27,4 ± 10,5ng/ml). After supplementation the level of 25(OH)D increased (p &lt; 0,001) in subgroup IB (37,28 ± 11,97ng/ml) and in subgroup IIB (36,4 ± 10,0ng/ml), and became higher (p &lt; 0,001) than in the comparable subgroups I and IIA. At baseline, subgroups IA and IB did not differ (p &gt; 0,05) by rate of morning SBP/DBP rise. In subgroup IIB rate of morning DBP rise was higher (p = 0,04) than in subgroup IIA. After therapy in subgroup IB there was a decrease rate of morning SBP/DBP rise (p &lt; 0,05); in subgroup IA, rate of morning SBP/DBP rise did not change (p &gt; 0,05). In subgroup IIA, there was no decrease (p = 0.62) rate of morning DBP rise, while in subgroup IIB, rate of morning DBP rise in the decreased (p &lt; 0,05) compared to the baseline and in comparison with rate of morning DBP rise in subgroup IIA after therapy (p = 0,04). The contribution of cholecalciferol to the dynamics of rate of morning DBP rise was established: F = 4,33, p = 0,04. Conclusions: Correction of 25(OH)D level by intake of cholecalciferol 2000 IU/day for 3 months leads to reduction of rate of morning BP rise in women with AH.

Multiparametric MRI radiomics nomogram for predicting lymph-vascular space invasion in early-stage cervical cancer.

To develop a radiomics nomogram based on multiparametric MRI (mpMRI) to pre-operatively predict lymph-vascular space invasion (LVSI) in patients with early-stage cervical cancer. This retrospective study included 233 consecutive patients with Stage IB-IIB cervical cancer. According to the ratio of 2:1, 154 patients and 79 patients were randomly assigned to the primary and validation cohorts, respectively. Features with intraclass and interclass correlation coefficient (ICCs) greater than 0.75 were selected for radiomics features. The significant features for predicting LVSI were selected using the least absolute shrinkage and selection operator (LASSO) algorithm based on the primary cohort. The rad-score for each patient was constructed via a linear combination of selected features that were weighted by their respective coefficients. The radiomics nomogram was developed using multivariable logistic regression analysis by incorporating the rad-score and clinical risk factors. A total of 19 radiomics features and 3 clinical risk factors were selected. The rad-score exhibited a good performance in discriminating LVSI with a C-index of 0.76 and 0.81 in the primary and validation cohorts, respectively. The radiomics nomogram also exhibited a good discriminating performance in two cohorts (C-index of 0.78 and 0.82). The calibration curve of the radiomics nomogram demonstrated no significant differences was found between prediction and observation outcomes for the probability of LVSI in two cohorts (p = 0.86 and 0.98, respectively). The decision curve analysis indicated that clinician and patients could benefit from the use of radiomics nomogram and rad-score. The nomogram and rad-score could be used conveniently and individually to predict LVSI in patients with early-stage cervical cancer and facilitate the treatment decision for clinician and patients. The nomogram could pre-operatively predict LVSI in early-stage cervical cancer.

How much hydrogen is in Type Ib and IIb supernova progenitors?

ABSTRACT Core-collapse supernovae showing little or no hydrogen (denoted by Type IIb and Ib, respectively) are the explosions of massive stars that have lost some or most of their outer envelopes. How they lose their mass is unclear, but it likely involves binary interaction. So far, seven progenitors of such supernovae have been identified in pre-explosion imaging (five for Type IIb events and two for Type Ib events). Here, we evolve detailed binary stellar evolution models in order to better understand the nature of these progenitors. We find that the amount of hydrogen left in the envelope at the time of explosion greatly depends on the post-interaction mass-loss rate. The leftover hydrogen, in turn, strongly affects progenitor properties, such as temperature and photospheric radius, in non-trivial ways. Together with extinction and distance uncertainties in progenitor data, it is difficult to deduce an accurate progenitor hydrogen mass from pre-explosion imaging. We quantify this uncertainty and find that available data are consistent with a proposed Type Ib–IIb hydrogen mass threshold of ${\approx}0.033\, \mathrm{M}_\odot$, implying that even Type Ib progenitors are not pure helium stars. These results alleviate the proposed tension between the Type Ib classification of SN 2019yvr and its candidate progenitor properties. We also estimate the brightness of a surviving 2019yvr progenitor companion, which might be detected in future observations.

Comparison of Characteristics and Survival Rates of Resectable Pancreatic Ductal Adenocarcinoma According to Tumor Location

Introduction: The impact of tumor location on patient survival in pancreatic ductal adenocarcinoma (PDAC) remains controversial. This study investigated the association between primary tumor location and survival rates for resectable PDAC. Method: We analyzed 2,471 PDAC patients who underwent surgical resection between 2000 and 2018 at a single center. The Kaplan-Meier survival curve and log-rank test were performed to compare overall and disease-free survival rates in patients with pancreatic head cancer (PHC) and those with pancreatic body/tail cancer (PBTC). The Cox proportional hazard model was used to evaluate the association between tumor location and survival as well as the prognostic factors for PDAC. Subgroup analysis was performed according to the TNM staging system. Results: Among the sample, 67.9% had PHC and 32.1% had PBTC. Patients with PHC had worse overall survival (24 months vs. 34 months, p < 0.001) and worse disease-free survival (12 months vs. 18 months, p < 0.001) than those with PBTC. Patients with PHC had worse survival in stage IB (36 months vs. 55 months, p = 0.011) and stage IIB (23 months vs. 31 months, p = 0.003) than those with PBTC. No significant difference was observed for stages IA, IIA, and III. Multivariate analysis showed that CA19-9, mGPS, operation time, adjuvant therapy, differentiation, N stage, lymphovascular invasion, and resection margin were risk factors for poor survival after resection. Conclusions: Patients with PHC had worse overall and disease-free survival than those with PBTC. However, tumor location was not an independent prognostic factor for pancreatic cancer.

Comparison of Characteristics and Survival Rates of Resectable Pancreatic Ductal Adenocarcinoma according to Tumor Location.

The impact of tumor location on patient survival in pancreatic ductal adenocarcinoma (PDAC) remains controversial. This study investigated the association between primary tumor location and survival rates for resectable PDAC. Additionally, we assessed if this association remains consistent across categories of the Tumor-Node-Metastasis staging system. We analyzed 2471 patients who underwent surgical resection between 2000 and 2018 at a single center. Subgroup analysis was performed according to the Tumor-Node-Metastasis staging system. Among the group, 67.9% (1677 patients) had pancreatic head cancer (PHC) and 32.1% (794 patients) had pancreatic body/tail cancer (PBTC). Patients with PHC had worse overall survival and worse disease-free survival than those with PBTC. Patients with PHC had worse survival in stage IB and stage IIB than those with PBTC. No significant difference was observed for stages IA, IIA, and III. Multivariate analysis showed that elevated CA 19-9, mGPS, a longer hospital stay, complication, accompanying vein resection, larger tumor size, worse differentiation, higher TNM stage (stage IIB, III, IV), presence of LVI, and positive resection margin were risk factors for poor survival after resection. In resectable PDAC, patients with PHC had worse overall and disease-free survival than those with PBTC. However, tumor location was not an independent prognostic factor for PDAC.

The Okabayashi Radical Hysterectomy: Basic Principle and Step-by-Step Procedure.

Abdominal radical hysterectomy is the standard operation for stage IB–IIB cervical cancer in the world, which was established by Professor Hidekazu Okabayashi in 1921. In this article, the basic principle and step-by-step procedure of Okabayashi radical hysterectomy are presented, especially for young doctors to understand clearly the important points of this surgery and to realize its radicality and safety for better survival and quality of life of patients with cervical cancer.

A new classification and strategies for endovascular treatment of celiac artery aneurysms.

Endovascular treatment is being increasingly used for celiac artery aneurysms (CAAs), but systematic endovascular treatment strategies have not been defined yet. This study intended to investigate the strategies of endovascular management of CAAs according to a single-center experience. Anatomically, CAAs were classified into two types: Type I CAAs located in the main trunk of celiac artery. Type II CAAs located on the branches of the celiac artery. Type I and Type II CAAs can be further divided into two different subtypes according to fusiform (a) or saccular or (b) morphology: type Ia, type Ib, type IIa, and type IIb. Patient demographics, clinical manifestations, aneurysm characteristics, endovascular intervention procedures, and perioperative and follow-up outcomes were reviewed and analyzed. Between August 2012 and August 2020, 18 consecutive patients (12 men; mean age, 56.8 ± 14.5years) with CAAs were identified and treated with endovascular procedures. There were seven patients with type Ia, three patients with type Ib, four patients with type IIa, and four patients with type IIb CAAs. One patient died of hemorrhagic shock due to a ruptured aneurysm. Technical success was achieved in 16 patients (88.9%). The mean follow-up period was 51.7 ± 19.4months. No hepatic or intestinal ischemia or death developed perioperatively or during the follow-up period. No aneurysmal expansion was detected on CTA surveillance, except for one patient who was diagnosed with an endoleak during the follow-up and received reintervention. The endovascular strategy based on the novel classification of CAAs was safe and effective, with a favorable mid-term clinical outcome.

Laterally extended parametrectomy

ObjectiveTo describe the laterally extended parametrectomy (LEP) surgical technique, emphasizing the main challenges of the procedure.MethodsLEP was designed as a more radical surgical procedure aiming to remove the entire parametrial tissue from the pelvic sidewall. Its initial indications were for lymph node positive Stage Ib (current International Federation of Gynecology and Obstetrics 2018 Stage IIIc) and Stage IIb cervical cancer. Currently, with most guidelines recommending definitive radiochemotherapy for these cases, initial LEP indications have become debatable. LEP is now mainly indicated for removing tumors involving the soft structures of the pelvic sidewall during a pelvic exenteration, aiming to obtain lateral free margins. This expands the lateral borders of the dissection to not only the medial surface of internal iliac vessels, but also to the true limits of the pelvic sidewall.ResultsDuring LEP, the parietal and visceral branches of the hypogastric vessels are divided at the entry and exit level of the pelvis. Consequently, the entire internal iliac system is excised, and no connective or lymphatic tissue remain on the pelvic sidewall. The main technical challenges of LEP are caused by the difficulty in ligating large caliber vessels (internal iliac artery and vein) and the variable anatomic distribution of pelvic sidewall veins.ConclusionLEP is a feasible technique for removing pelvic sidewall recurrences, aiming to obtain surgical free margins.

Chlormethine Gel in Combination with Other Therapies in the Treatment of Patients with Mycosis Fungoides Cutaneous T Cell Lymphoma: Three Case Reports

IntroductionChlormethine gel is a skin-directed therapy recommended for patients with early-stage mycosis fungoides (MF) cutaneous T cell lymphoma.MethodsHerein, we present three cases of patients with stage IB–IIB MF who were treated with chlormethine gel and concomitant therapies.ResultsAll patients responded well to treatment with chlormethine gel; complete responses were observed with improvements in Modified Severity-Weighted Assessment Tool scores and severity of lesions; one patient reported an improvement in quality of life. While adverse events did occur after treatment initiation, they were skin related and could be effectively managed through reductions in treatment frequency and the addition of emollients and topical steroids.ConclusionThe cases presented here illustrate that chlormethine gel is an effective and safe treatment option for patients with MF who had received prior therapies that had proved ineffective. Chlormethine gel could be combined with other skin-directed or systemic therapies for optimal benefit. Incidences of dermatitis were seen to be successfully managed and quality of life benefits were also reported.

Combination of weekly paclitaxel-carboplatin plus standard bevacizumab as neoadjuvant treatment in stage IB–IIB cervical cancer

ObjectiveIn this study we investigated response rates of bevacizumab in addition to weekly paclitaxel and carboplatin in neoadjuvant setting in cervical cancer stage IB–IIB.MethodsIn this retrospective study we included patients...

EFFECT OF CHOLECALCIFEROL ON PULSE WAVE VELOCITY IN WOMEN WITH ARTERIAL HYPERTENSION IN PREMENOPAUSAL AND EARLY POSTMENOPAUSAL PERIODS

Abstract Objective: Aim: To assess effect of cholecalciferol on pulse wave velocity (PWV) in women with arterial hypertension (AH) in premenopausal and early postmenopausal periods who received 25 (OH)D supplementation. Design and method: Materials and methods: We investigated 102 women with AH stage II risk 3 aged 50 (48; 53) years: 50 females in premenopausal period – group I and 52 females in early postmenopausal period – group II. Serum level of 25 (OH)D was determined by the immunoenzymatic assay. In groups I and II we identified subgroups with the level of 25 (OH)D &lt; 30ng/ml: subgroup IB (n = 25) and subgroup IIB (n = 21) respectively, in which antihypertensive therapy was supplemented with cholecalciferol 2,000 IU/day for 3 months. In subgroups IA (n = 25) and IIA (n = 31) cholecalciferol was not administered. The PWV was determined by assessing the elastic properties of blood vessels using computer rheovasography. Statistical analysis was performed by means of «STATISTICA 10.0». Results: Results: At baseline the level of 25 (OH)D was lower (p &lt; 0,05) in subgroups IB (19,3 ± 8,5ng/ml) and IIB (18,2 ± 9,5ng/ml) than in the comparable subgroups IA (26,7 ± 11,5ng/ml) and IIA (27,4 ± 10,5ng/ml). After supplementation the level of 25 (OH)D increased (p &lt; 0,001) in subgroup IB (37,28 ± 11,97ng/ml) and in subgroup IIB (36,4 ± 10,0ng/ml), and became higher (p &lt; 0,001) than in the comparable subgroups I and IIA. At baseline subgroups IA and IB, IIA and IIB did not differ (p &gt; 0,05) by PWV. Following the therapy PWV decreased (p &lt; 0,01) in all groups. However, the PWV was significantly lower (p &lt; 0,05) in subgroups IB (3,7 (3,1;4,3) m/s) and IIB (4,1 (3,6; 4,5) m/s) than in the comparable subgroups IA (4,2 (3,6; 5,2)m/s) and IIA (4,8 (4,0;5,6) m/s), correspondingly. Conclusions: Conclusion: Correction of 25 (OH)D level by intake of cholecalciferol 2000 IU/day for 3 months leads to reduction of PWV in women with AH.

A randomized phase III trial of adjuvant chemotherapy versus concurrent chemoradiotherapy for postoperative cervical cancer: Japanese Gynecologic Oncology Group study (JGOG1082)

BackgroundThe standard treatment for stage IB–IIB cervical cancer is radiotherapy or radical hysterectomy; after radical hysterectomy, adjuvant concurrent chemoradiotherapy is recommended for patients with high risk factors. However, adjuvant concurrent...