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1

Intraarterial chemotherapy for bulky uterine cervical carcinoma  

International Nuclear Information System (INIS)

Objective: To evaluate the effects of intraarterial chemotherapy for bulky uterine cervical carcinoma. Methods: One hundred untreated patients with stage I b-III a uterine cervical carcinoma were included in the study. Intraarterial chemotherapy was undertaken with a combination of Cisplatin (DDP) 50 mg/m2 or Paraplatin 300 mg/m2, Epiadriamycin (E-ADM) 45 mg/m2 one time/2ws. Results: The overall response rate was 87.0%. Radical hysterectomy was performed in 73 patients with less bleeding and shorter operative time than those of untreated group. The major adversary effects were leukocytopenia, nausea, and vomiting. Conclusions: Intraarterial chemotherapy is effective for preoperative treatment of uterine cervical cancer with easier radical hysterectomy, especially for inoperable bulky ones. (authors)

2004-12-01

2

Intra-arterial chemotherapy and irradiation for uterine cervical cancer  

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Treatment results of intra-arterial chemotherapy and irradiation for uterine cervical cancer were reviewed. Although several studies have been performed, its therapeutic value has not been determined. The use of this strategy for uterine cervical cancer cannot be recommended as standard treatment and should be restricted to well designed prospective clinical trials. (author)

Toita, Takafumi; Ogawa, Kazuhiko; Kakinohana, Yasumasa [Ryukyus Univ., Nishihara, Okinawa (Japan). Shool of Medicine] [and others

1998-06-01

3

[Uterine cervical carcinoma and pericardial effusion].  

Science.gov (United States)

A 64-year-olf woman has been treated by chemotherapy for a uterine cervical carcinoma with known pathological lymph nodes in the abdomen and in the thorax. She is admitted in our Intensive Care Unit for fever and cardiac tamponade attributed to a large pericardial effusion. No diagnostic could be concluded from the analysis of the liquid or the pericardial biopsy. Complementary investigations are performed and the differential diagnosis of pericardial effusion is discussed in the context of a neoplastic disease. PMID:18069518

Vokaer, B; Machiels, J P; Vansnick, F; Castaigne, C; Feoli, F; Dediste, A; Sculier, J P

2007-01-01

4

Staging of uterine cervical carcinoma on MRI  

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In a prospective study the results of FIGO staging and MR staging in uterine cervical carcinoma were compared with the findings of stepwise serial examination of en-bloc-resected specimens in 28 patients. Overall accuracy of MR staging was 59% compared to 41% in FIGO staging. Sensitivity in assessing parametrial tumour extension was 85% in MRI and 64% in clinical examination. Specificity was 74% in MRI and 69% in physical examination. Accuracy in parametrial tumour extension was 67% in FIGO-Classification and 80% in MRI. (orig.)

1990-01-01

5

Recurrent Uterine Cervical Carcinoma: Spectrum of Imaging Findings  

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Uterine cervical carcinoma is one of the most common malignant tumors occurring in females. After primary treatment, patients are usually followed up with CT or MRI and the findings of these modalities may be the first sign of recurrent disease. Because earlier additional treatment by chemotherapy or radiation therapy may improve the prognosis, the early detection of recurrent cervical carcinoma is clinically important. In this article, we review the CT and MR imaging findings of recurrent ut...

2000-01-01

6

Uterine cervical cancer. Preoperative staging with magnetic resonance imaging  

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The treatment of uterine cervical carcinoma is largely dependent on the tumor stage. Despite significant inaccuracies in the clinical examination, uterine cervical cancer remains the only gynecological form of cancer still largely staged according to clinical findings. Although imaging is still not included in the staging the recently published revised FIGO (Federation International de Gynecologie et d'Obstetrique) system encourages the use of modern cross-sectional imaging (magnetic resonance imaging MRI and computed tomography CT). Due to its high soft tissue contrast MRI allows excellent non-invasive assessment of the cervix with direct tumor delineation as well as assessment of the prognosis based on morphological factors. Studies in the literature report an accuracy of 93% for MRI in the preoperative assessment of tumor size and in the differentiation of operable from advanced cervical cancer. Therefore MRI is considered to be the optimal modality for diagnostic evaluation starting from FIGO stage IB1, for radiation therapy planning, and for exclusion of recurrence in follow-up. In this paper we give an overview of the role of magnetic resonance imaging in preoperative staging of uterine cervical cancer. (orig.)

2011-07-01

7

Uterine cervical tubulosquamous polyp resembling a penis.  

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This case report describes a tubulosquamous polyp resembling a penis in the uterine cervix. A 34-yr-old, gravida 0, para 0, woman showed an 18 × 8 × 5 mm polypoid lesion in the uterine ectocervix. The polyp had a penis-like appearance; the tip looked like glans penis and the middle portion resembled the shaft of the penis. Its surface was covered by squamous epithelium, and tissues resembling those of a urethra, corpus spongiosum penis, and external orifice urethra were observed. Foreskin-like tissues were also observed, although a corpus cavernosum penis was not seen. Skene glands and Cowper glands were also observed. Immunohistochemically, Skene glands and the urethra-like epithelium were focally positive for prostate-specific antigen and/or prostatic acid proteins. Histologically and immunohistochemically, the polypoid lesion overlapped with a tubulosquamous polyp of the vagina and ectopic prostatic tissue of the uterine cervix and encompassed these lesions in the lower female genital tract. The most likely theory of histogenesis is a developmental anomaly and misplacement of Skene glands. PMID:23722517

Fukunaga, Masaharu

2013-07-01

8

Pharmacokinetics of adriamycin vaginal suppository on uterine cervical cancer  

International Nuclear Information System (INIS)

Vaginal suppositories of Adriamycin (ADM, 5 mg), for reducing the capacity for repair from sublethal damage of X-ray-irradiated cells, were prepared using Wipepsol S-55 as the vehicle, and were intravaginally administered to patients with advanced uterine cervical cancer, and their pharmacokinetics and clinical effects were studied. The ADM concentration in the uterine cervical cancer tissues indicated high levels (17 to 566 ?g/g), and migration into the cardinal ligament and regional lymph nodes was noted. However, little ADM was detected in serum (0 to 0.14 ?g/g), probably because of its molecular weight and excellent tissue absorbance, and no side effects, such as cardiotoxicity and myelosuppression due to consecutive administration were detected. Histologically, the effect obtained when administered alone was limited, administration in combination with radiotherapy being more effective. Accordingly, radiotherapy of advanced uterine cervical cancer with concomitant administration of ADM vaginal suppositories seems to bring about a more powerful antitumoral effect with fewer systemic side effects. (author)

1986-01-01

9

Short-course palliative radiotherapy for uterine cervical cancer  

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The purpose of this retrospective study was to evaluate the efficacy and feasibility of short-course hypofractionated radiotherapy (RT) for the palliation of uterine cervical cancer. Seventeen patients with cancer of the uterine cervix, who underwent palliative hypofractionated 3-dimensional conformal radiotherapy between January 2002 and June 2012, were retrospectively analyzed. RT was delivered to symptomatic lesions (both the primary mass and/or metastatic regional lymph nodes). The total dose was 20 to 25 Gy (median, 25 Gy) in 5 Gy daily fractions. The median follow-up duration was 12.2 months (range, 4 to 24 months). The median survival time was 7.8 months (range, 4 to 24 months). Vaginal bleeding was the most common presenting symptom followed by pelvic pain (9 patients). The overall response rates were 93.8% and 66.7% for vaginal bleeding control and pelvic pain, respectively. Nine patients did not have any acute side effects and 7 patients showed minor gastrointestinal toxicity. Only 1 patient had grade 3 diarrhea 1 week after completion of treatment, which was successfully treated conservatively. Late complications occurred in 4 patients; however, none of these were of grade 3 or higher severity. Short-course hypofractionated RT was effective and well tolerated as palliative treatment for uterine cervical cancer.

Kim, Dong Hyun; Lee, Ju Hye; Ki, Yong Kan; Kim, Won Taek; Park, Dahl; Kim, Dong Won [Dept. of Radiation Oncology, Biomedical Research Institute, Pusan National University Hospital, Busan (Korea, Republic of); Nam, Ji Ho; Jeon, Sang Ho [Dept. of Radiation Oncology, Pusan National University Yangsan Hospital, Yangsan (Korea, Republic of)

2013-12-15

10

Assessment of Cervical Erosion in Hamedan City, Iran  

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Full Text Available The purpose of this study was to determine the role of socio-economic factors and cytology in cervical erosion. A cross-sectional study involving 410 females in the reproductive age group was conducted in urban health centers in Hamedan city, Iran. Data were collected through interviews with women, gynecological examination in the clinics in the health centers and laboratory tests. Cervical erosion was detected in 68 (16.6% females. Out of these mild dysplasia was seen in (8.8% females. High percentages of inflammatory smears (58.8% were obtained in women with cervical erosion. Cervical erosion was more common in illiterate and women with low literacy status as compared to women with higher education. Majority of cases of cervical erosion were detected in women with high parity. A statistically significant relationship was found between lower socio-economic status and cervical erosion (p< 0.05. Regular cytological screening by Pap smear will help in early detection of carcinoma cervix.

Fatemeh Shobeiri

2007-01-01

11

Second cancer after radiotherapy of the uterine cervical cancer  

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To study the relative risk of second cancer after radiotherapy, we reviewed 2465 cases of uterine cervical cancer who were treated in our institute from 1962 to 1986 and were followed up for more than 5 years. Among them, 1502 cases were treated by radiotherapy with or without surgery (radiotherapy group), and the remainder were treated by surgery only (surgery only group). We defined second cancer as malignancy that occurred in another organ after an interval of 5 years or more from the end of treatment of the first cancer. The relative risk of second cancer was computed by the person-year method advocated by Schoenberg. Second cancer was observed among 8 cases of the surgery group, whereas 43 cases were observed among the radiotherapy group. The cases were: rectal cancer, 6 cases; bladder cancer, 4 cases. The observed and expected ratio (O/E ratio) was 4.02 in rectal cancer and 7.98 in bladder cancer. This incidence of the both cancers was significantly high in the radiotherapy group. Three of the 6 cases with rectal cancer underwent operation in our institute. The incubation periods between the first and second cancers were from 9 to 21 years. Each case exhibited symptoms of chronic radiation proctitis after radiotherapy for uterine cervical cancer. It is thought necessary to follow up such cases carefully to detect radiation induced cancer. (author).

Koizumi, Tadashi; Soejima, Toshinori; Hirota, Saeko; Obayashi, Kayoko; Ishida, Teruko; Takada, Yoshiki; Yoshida, Shoji; Kimura, Shuji (Hyogo Medical Center for Adults, Akashi (Japan))

1993-09-01

12

Air in vagina: significance in the staging of uterine cervical carcinoma  

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To evaluate the significance of vaginal air seen on CT scan in preoperative staging of uterine cervical carcinoma. A comparison was made between CT findings of vaginal fir and true vaginal involvement status in 85 patients with uterine cervical carcinoma. CT findings were analyzed in terms of the presence or absence of vaginal air, number of CT slices in which vaginal air was seen, shape of vaginal air, and relation of vaginal air to cervical mass. Vaginal air was present in 35 patients and was absent in 50. Although the mere presence of vaginal air or multiplicity of CT slices showing vaginal air did not signify the presence of vaginal involvement, vaginal air with irregular margin or vaginal air adjacent to uterine cervical mass was suggestive of vaginal involvement. These observation of vaginal air in interpreting CT may be helpful in the preoperative staging of uterine cervical carcinoma

1994-01-01

13

Lumber and cervical osseous erosions secondary to herniated disks  

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Only seven cases of lumber vertebral body or lateral recess enlargement have been reported previously in the English-language literature. The authors studied six cases of herniated nucleus pulposus (HNP) that was causing bone erosion. Five were in the lumbar spine, and one was in the cervical spine. All five lumbar HNPs were eroding the osseous contours of the lateral recess (the posterior vertebral body and pedicles). Two of the lumbar disks were sequestered posterolaterally and also were eroding the lamina aggressively. The cervical HNP had resulted in erosion of intervertebral foramen, posterior vertebral body, and pedicle. Myelography, CT, and MR imaging all demonstrated the epidural defect. However, only CT convincingly demonstrated the bone erosion

1989-12-01

14

Radiotherapy results for recurrent uterine cervical cancer after surgery  

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To evaluate prognostic factors and survival rates of the patients who received radiation therapy for locally recurrent uterine cervical cancer after curative surgery. Between October 1983 and July 1996, fifty three patients who received radiation therapy for locally recurrent cervical cancer after curative surgery at the Department of Therapeutic Radiology, Kangnam St. Mary's Hospital, The Catholic University of Korea were analysed retrospectively. Age at diagnosis ranged from 33 to 69 years (median 53 years). Pathological analysis showed that forty five (84.9%) patients had squamous cell carcinoma, seven (13.2%) patients had adenocarcinoma, and one (1.9%) patient had adenosquamous cell carcinoma. The interval between hysterectomy and tumor recurrence ranged from 2 months to 25 years (mean 34.4 months). The recurrent sites were vaginal stump in 41 patients (77.4%) and pelvic side wall in 12 patients (22.6%). Recurrent tumor size was divided into two groups: less than 3 cm in 43 patients (81.1%) and more than 3 cm in 10 patients (18.9%). External beam irradiation of whole pelvis was done first up to 46.8 Gy to 50.4 Gy in 5 weeks to 6 weeks, followed by either external beam boost to the recurrent site in 18 patients (34%) or intracavitary irradiation in 24 patients (45.3%). Total dose of radiation ranged from 46.8 Gy to 111 Gy (median 70.2 Gy). Follow up period ranged from 2 to 153 months with a median of 35 months. Overall response rate was 66% (35/53). Among them, six patients (17.1%) relapsed between 7 months and 116 months after radiation therapy (mean 47.7 months). Therefore overall recurrence rate was 45.3%. Overall five-year actuarial survival rate was 78.9% and distant failure rate was 10% (5/50). The significant prognostic factors affecting survival rate were interval between primary surgery and tumor recurrence (p=0.0055), recurrent tumor size (p=0.0039), and initial response to radiation therapy (p=0.0428). Complications were observed in 10 (20%) patients, which included mild to moderate lower gastrointestinal, genitourinary, or skin manifestations. One patient died of pulmonary embolism just after intracavitary irradiation. Radiation therapy is the effective treatment for the patients with locally recurrent cervical cancer after curative surgery. These results suggest that interval between primary surgery and tumor recurrence, recurrent tumor size, and initial response to radiation therapy were significant prognostic factors for recurrent cervical cancer

1999-06-01

15

Postirradiation sarcoma (malignant fibrous histiocytoma) following uterine cervical cancer  

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A case of postirradiation sarcoma, a malignant fibrous histiocytoma, is described. The tumor occurred in the radiation field (the buttock) 8 years after radiation therapy for keratinizing squamous cell carcinoma of the uterine cervix. The 68-year-old female patient with the inital diagnosis of cervical cancer was treated with pelvic irradiation in 1973. She did well after that with no evidence of disease until 1981 when she developed an enlarging mass in the right buttock within the field of the previous radiation therapy. Microscopically, the tumor at biopsy was composed of pleomorphic histiocyte-like cells, spindle-sphaped cells arranged in a storiform pattern and multinucleated giant cells with bizarre nuclei. Cytodiagnostically, two types of cells, fibroblast-like cells ane histiocyte-like cells, were found. And some cells were considered to be transitional forms, intermediate between fibroblast and histiocytes. Multinucleated pleomorphic giant cells were sometimes seen. Ultrastructurally, the same types of cells were confirmed. These cells contained large numbers of rough endoplasmic reticula with dilated lumens, vacuoles, lysosomal structures, and lipid droplets. (author)

1984-01-01

16

Variable uterine uptake of FDG in adenomyosis during concurrent chemoradiation therapy for cervical cancer  

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To avoid improper tumor volume contouring in radiation therapy (RT) and other invasive procedures, we report a case of uterine adenomyosis showing increased 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT) mimicking malignant tumor in a 44-year-old woman during concurrent chemoradiation therapy (CCRT) for uterine cervical cancer. The adenomyosis was not associated with her menstrual cycle or with normal endometrium uptake, and it resolved one ...

Yu, Jeong Il; Huh, Seung Jae; Kim, Young Il; Kim, Tae-joong; Park, Byung Kwan

2011-01-01

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High-dose-rate brachytherapy in uterine cervical carcinoma  

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Purpose: High-dose-rate (HDR) brachytherapy is in wide use for curative treatment of cervical cancer. The American Brachytherapy Society has recommended that the individual fraction size be <7.5 Gy and the range of fractions should be four to eight; however, many fractionation schedules, varying from institution to institution, are in use. We use 9 Gy/fraction of HDR in two to five fractions in patients with carcinoma of the uterine cervix. We found that our results and toxicity were comparable to those reported in the literature and hereby present our experience with this fractionation schedule. Methods and Materials: A total of 121 patients with Stage I-III carcinoma of the uterine cervix were treated with HDR brachytherapy between 1996 and 2000. The total number of patients analyzed was 113. The median patient age was 53 years, and the histopathologic type was squamous cell carcinoma in 93% of patients. The patients were subdivided into Groups 1 and 2. In Group 1, 18 patients with Stage Ib-IIb disease, tumor size <4 cm, and preserved cervical anatomy underwent simultaneous external beam radiotherapy to the pelvis to a dose of 40 Gy in 20 fractions within 4 weeks with central shielding and HDR brachytherapy of 9 Gy/fraction, given weekly, and interdigitated with external beam radiotherapy. The 95 patients in Group 2, who had Stage IIb-IIIb disease underwent external beam radiotherapy to the pelvis to a dose of 46 Gy in 23 fractions within 4.5 weeks followed by two sessions of HDR intracavitary brachytherapy of 9 Gy each given 1 week apart. The follow-up range was 3-7 years (median, 36.4 months). Late toxicity was graded according to the Radiation Therapy Oncology Group criteria. Results: The 5-year actuarial local control and disease-free survival rate was 74.5% and 62.0%, respectively. The actuarial local control rate at 5 years was 100% for Stage I, 80% for Stage II, and 67.2% for Stage III patients. The 5-year actuarial disease-free survival rate was 88.8% for Stage I, 76.52% for Stage II, and 50.4% for Stage III patients. Local failure occurred in 2 (11.1%) of the 18 Group 1 patients and in 20 (21.0%) of the 95 Group 2 patients. Distant failure occurred in none of the Group 1 patients and in 8 (8.4%) of the 95 Group 2 patients. None of the patients developed Grade 3 rectal toxicity. Grade 3 bladder toxicity was observed in 2 patients. The actuarial risk of Grade 3 or worse late toxicity was 3.31%. Conclusion: The results of our study indicate that HDR brachytherapy at 9 Gy/fraction is both safe and effective in the management of carcinoma of the cervix, with good local control and a minimum of normal tissue toxicity

2005-05-01

18

Variable uterine uptake of FDG in adenomyosis during concurrent chemoradiation therapy for cervical cancer  

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To avoid improper tumor volume contouring in radiation therapy (RT) and other invasive procedures, we report a case of uterine adenomyosis showing increased 18F-fl uorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT) mimicking malignant tumor in a 44-year-old woman during concurrent chemoradiation therapy (CCRT) for uterine cervical cancer. The adenomyosis was not associated with her menstrual cycle or with normal endometrium uptake, and it resolved one month after completion of RT. This case indicates that uterine adenomyosis in a premenopausal woman may show false positive uptake of 18FDG-PET/CT associated with CCRT.

Yu, Jeong Il; Huh, Seung Jae; Kim, Young Il; Kim, Tae Joong; Park, Byung Kwan [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2011-09-15

19

Variable uterine uptake of FDG in adenomyosis during concurrent chemoradiation therapy for cervical cancer  

International Nuclear Information System (INIS)

To avoid improper tumor volume contouring in radiation therapy (RT) and other invasive procedures, we report a case of uterine adenomyosis showing increased 18F-fl uorodeoxyglucose (FDG) uptake on positron emission tomography (PET)/computed tomography (CT) mimicking malignant tumor in a 44-year-old woman during concurrent chemoradiation therapy (CCRT) for uterine cervical cancer. The adenomyosis was not associated with her menstrual cycle or with normal endometrium uptake, and it resolved one month after completion of RT. This case indicates that uterine adenomyosis in a premenopausal woman may show false positive uptake of 18FDG-PET/CT associated with CCRT.

2011-09-01

20

External beam boost irradiation for clinically positive pelvic nodes in patients with uterine cervical cancer  

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The purpose of this study was to retrospectively analyze the treatment results of boost external beam radiotherapy (EBRT) to clinically positive pelvic nodes in patients with uterine cervical cancer. The study population comprised 174 patients with FIGO stages 1B1–4A cervical cancer who were treated with definitive radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT). Patients with positive para-aortic or common iliac nodes (?1...

2013-01-01

 
 
 
 
21

Diagnosis of recurrent uterine cervical cancer: computed tomography versus positron emission tomography  

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To determine the accuracy of CT and positron emission tomography (PET) in the diagnosis of recurrent uterine cervical cancer. Imaging findings of CT and PET in 36 patients (mean age, 53 years) in whom recurrent uterine cervical cancer was suspected were analyzed retrospectively. Between October 1997 and May 1998, they had undergone surgery and/or radiation therapy. Tumor recurrence was confirmed by pathologic examination or follow-up studies. In detecting recurrent uterine cervical cancer, the sensitivity, specificity, and accuracy of CT were 77.8%, 83.3%, and 80.5%, respectively, while for PET, the corresponding figures were 100%, 94.4%, and 97.2%. The Chi-square test revealed no significant difference in specificity (p= .2888), but significant differences in sensitivity (p= .0339) and accuracy (p= .0244). PET proved to be a reliable screening method for detecting recurrent uterine cervical cancer, but to determine the anatomical localization of recurrent tumors, and thus decide an adequate treatment plan, CT was eventually needed.

Park, Dong Hee; Kim, Kie Hwan; Park, Sang Yoon; Lee, Byung Hee; Choi, Chang Woon; Chin, Soo Yil [Korea Cancer Center Hospital, Seoul (Korea, Republic of)

2000-03-01

22

Role of FDG-PET in initial workup of uterine cervical cancer  

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FDG-PET is widely utilized in gynecologic malignancies. In uterine cervical cancer, although CT, MRI and PET are not included for the most widely used FIGO staging, they may provide useful information additional to clinical stage. We thus investigated the role of FDG-PET in the initial workup of uterine cervical cancer. A total of 85 newly diagnosed uterine cervical cancer patients were included (mean age 50{+-}12yr). Patients previously treated for the cancer were excluded, but conization was an exception. Attenuation corrected whole body PET was interpreted by two nuclear medicine physicians. Suspicious malignant lesions on PET were confirmed by surgical biopsy or other imaging studies. Main tumor masses were detected by FDG-PET in 79 patients (93%). PET detected 15 iliac and 8 paraaortic lymph nodes with increased uptake that was suggested to be metastatic based on other modalities. Among patients who had surgical confirmation of lymph node status, 36 of 40 (90%) patients without lymph node metastasis had concordant PET findings, while PET correctly detected 5 of 16(31%) lymph node metastases. In 8/85 patients (9%), FDG-PET detected distant metastastic lesions which had not been detected by other modalities. Of these patients, treatment modality was changed in 1 and the radiation field was modified in 3 patients. FDG-PET is useful for detecting unidentified metastastic lesions in the initial workup of uterine cervical cancer, and may thus aid in decisions for optional therapeutic strategies.

Jang, H. J.; Lee, K. H.; Lee, E. J.; Kim, Y. H.; Yoon, J. K.; Choi, Y.; Choe, Y. S.; Kim, S. E.; Lee, J. H.; Kim, B. T. [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

2002-07-01

23

Metastatic Breast Cancer to the Uterine Cervix Mimicking a Giant Cervical Leiomyoma  

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Full Text Available Metastasis to the uterine cervix is a complication of breast cancer that is not commonly known. Detection of cervical metastasis before the diagnosis of the primary tumor is even rarer. The present report describes a case of a 52-year-old woman who had a large cervical tumor appearing as a leiomyoma. She underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathological examination of the cervical tumor showed patterns characteristic of invasive lobular carcinoma of the breast, leading to the discovery of the primary in the left breast. She subsequently underwent mastectomy, hormone therapy and chemotherapy, and is alive at 7-year follow-up.

MAI HORIKAWA

2012-08-01

24

Value of intramuscular methotrexate and bilateral uterine artery embolization for treating cervical ectopic pregnancy  

International Nuclear Information System (INIS)

Objective: To assess the clinical value of bilateral uterine artery chemotherapy embolization (UACE) for cervical ectopic pregnancy analyzed. Methods: Clinical records of 40 patients with cervical ectopic pregnancy treated using UACE were retrospectively analyzed. Results: 8 patients with severe active vaginal bleeding after curettage were treated urgently with UACE. The remaining 32 patients were treated with UACE combined with sequential ultrasound-guided curettage. Active vaginal bleeding was stopped after UACE. There was no recurrent hemorrhage with the sequential ultrasound-guided curettage procedure. The ?-HCG levels of all patients were normalized after 1 month. Conclusion: Bilateral uterine artery chemotherapy embolization is valuable as emergency treatment for patients with severe vaginal bleeding from cervical ectopic pregnancy. UACE combined with sequential ultrasound-guided curettage may be more effective. (authors)

2011-12-01

25

Fertility-sparing operation for recurrence of uterine cervical perivascular epithelioid cell tumor  

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Full Text Available Perivascular epithelioid cell tumors (PEComa are mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epithelial cells. Although the uterine corpus seems to be one of the most prevalent sites of involvement, PEComa of the uterine cervix are very rare. Only four cervical PEComa cases have been described, and were treated with hysterectomy and radiotherapy. We report a case of a 24-year-old nulli­gravida woman who presented with acute abdominal pain and was diagnosed with a rupture of an ovarian chocolate cyst. Subsequent surgery revealed that the tumor arose in the uterus, and the histological diagnosis was uterine PEComa with low potential malignancy. Recurrent PEComa in the uterine cervix were excised twice, and she remains disease free 12 months after the last operation. To the best of our knowledge, this is the first report of recurrent cervical PEComa with fertility-preserving surgery. Estimating the malignant potential and appropriate surgery are essential for young patients with uterine PEComa.

Fumitaka Kikkawa

2010-06-01

26

Superselective uterine artery chemoembolization for the treatment of cervical cancer: a clinical analysis of 33 cases  

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Objective: To discuss the clinical therapeutic effect and side reaction of superselective uterine arterial chemoembolization therapy for the treatment of cervical cancer. Methods: Bilateral uterine arterial chemoembolization was performed in 33 patients with pathologically-proved cervical cancer. The infusion drugs included DDP or L-OHP, EADM, MMC and 5-Fu. The Gelfoam particle was employed as embolic agent. The therapeutic effect evaluated by observing the improvement of clinical symptoms and the volume reduction of the tumor. Results: Of the total 33 patients with pathologically-confirmed cervical cancer, squamous cell carcinoma was seen in 29 and adenocarcinoma in 4. Based on FIGO classification (established by Federation International of Gynecology and Obstetrics), 6, 23 and 4 patients were classified in stage ?, ? and ? respectively. The angiography conducted during the procedure showed that the uterine arteries were markedly dilated, and spiral tumor-feeding arteries as well as tumor stain were also observed. Technical success together with perfect chemoembolization was achieved for 57 uterine arteries in 33 patients. Among the 33 patients, the interventional treatment was carried out three times in 2, two times in 2 and single time in 29. One week after the initial interventional procedure the remission rate of the clinical symptoms was 96% for squamous cell carcinoma and 100% for adenocarcinoma. One month after the treatment, the mean tumor volume was decreased by 30%, the tumor volume reduction for squamous cell carcinoma was 27.6% and was 50.0% for adenocarcinoma. Surgical resection after interventional therapy was carried out in 21 cases and additional radiotherapy after surgery or interventional procedure was adopted in 11 cases. The main adverse reactions after interventional procedure included fever, leucocytopenia, nausea, vomiting, abdominal pain, etc. Conclusion: Superselective uterine arterial chemoembolization is one of effective supplementary measures for the comprehensive treatment of cervical carcinoma. (authors)

2011-04-01

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Case Report: Uterine Adenocarcinoma Metastasis to the Skull Base and Cervical Spine Presenting with Pathological Fracture and Myelopathy  

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Objective: The authors report a rare case of uterine adenocarcinoma metastasis to both the skull base and cervical spine presenting with pathological fracture and myelopathy. Methods: We report the case of a 43-year-old Asian female with widely metastatic uterine adenocarcinoma who over the course of 3 years was diagnosed with a large clival mass and more recently a cervical spine pathological fracture presenting...

Kaloostian, Paul E.; Han Chen; Martina Stippler

2013-01-01

28

Comparison of human uterine cervical electrical impedance measurements derived using two tetrapolar probes of different sizes  

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Full Text Available Abstract Background We sought to compare uterine cervical electrical impedance spectroscopy measurements employing two probes of different sizes, and to employ a finite element model to predict and compare the fraction of electrical current derived from subepithelial stromal tissue. Methods Cervical impedance was measured in 12 subjects during early pregnancy using 2 different sizes of the probes on each subject. Results Mean cervical resistivity was significantly higher (5.4 vs. 2.8 ?m; p in vivo followed the pattern predicted by the finite element model. Conclusion Inter-electrode distance on the probes for measuring cervical impedance influences the tissue resistivity values obtained. Determining the appropriate probe size is necessary when conducting clinical studies of resistivity of the cervix and other human tissues.

Brown Brian H

2006-11-01

29

Uterine cervical cancer. Usefulness of MR imaging after the initial radiation therapy  

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To evaluate the usefulness of magnetic resonance imaging (MRI) in diagnosing residual or recurrent tumors of cervical cancer after radiation therapy, we investigated the time difference between MRI and gynecologic findings in the diagnosis of residual or recurrent tumor in 12 patients with invasive cervical cancer. We defined a positive finding for residual or recurrent tumor as an uterine cervical mass isointense to muscle on T1-weighted images and hyperintense on T2-weighted images, and when a positive biopsy specimen was obtained. Two patients were diagnosed as having a residual or recurrent tumor by MRI. Positivity was demonstrated four and seven months later, respectively. MRI was more useful in the earlier diagnosis of residual or recurrent tumor of cervical cancer after radiation therapy than uterine biopsy. There was one patient whose differentiation from residual tumor or radiation-induced necrosis or inflammation on MRI was difficult. MRI and gynecologic check-up at a regular interval after radiation therapy was needed to distinguish them. One patient was diagnosed as having a recurrent tumor by gynecologic finding three months earlier than by MRI. Follow-up MRI examinations at a regular interval in addition to gynecologic examination is necessary for the early detection of recurrent cervical cancer after radiation therapy. (author).

Monzen, Yoshio [Hiroshima Prefectural Hiroshima Hospital (Japan); Mori, Hiromu; Matsumoto, Akira; Yoshida, Shintaro; Wakisaka, Masaki; Komatsu, Eiji; Tashiro, Makoto; Hori, Yuko

1995-09-01

30

Cerebellar metastases in patients with uterine cervical cancer. Two cases reports and review of the literature  

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Brain metastases from cervical cancer are extremely rare. We report on two patients who developed cerebellar metastases following uterine cervical cancer. The interval between diagnosis of the primary cancer and diagnosis of brain metastasis was 8 months. The main complaint was symptoms of increased intracranial pressure and cerebellar syndrome. Surgical excision of the brain lesion followed by radiation therapy was performed in the first case. The second patient received palliative radiation therapy. The first patient died 8 months after diagnosis. The second patient is alive 2 months after diagnosis. (authors)

2003-10-01

31

Different strategies of treatment for uterine cervical carcinoma stage IB2-IIB  

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Uterine cervical cancer is the second most common gynecological malignancy. It is estimated that over 35% of tumors are diagnosed at locally advanced disease, stage?IB2-IIB with an estimated 5-year overall survival of 60%. During the last decades, the initial treatment for these women has been debated and largely varies through different countries. Thus, radical concurrent chemoradiation is the standard of care in United Sated and Canada, and neoadjuvant chemotherapy followed by radical surgery is the first line of treatment in some institutions of Europe, Asia and Latin America. Until today, there is no evidence of which strategy is better over the other. This article describe the evidence as well as the advantages and disadvantages of the main strategies of treatment for women affected by uterine cervical cancer stage?IB2-IIB.

Minig, Lucas; Patrono, Maria Guadalupe; Romero, Nuria; Rodriguez Moreno, Juan Francisco; Garcia-Donas, Jesus

2014-01-01

32

Clinical evaluation of high dose rate intra-cavitary irradiation for treatment of uterine cervical cancer, combined with pepleomycin suppository in uterine cavity  

International Nuclear Information System (INIS)

By means of re-irradiation using pepleomycin suppository in uterine cavity, we attained local control for one patient who had local recurrence in uterine cavity and suffered from uterine fluor in which viable cancer cells were confirmed. We were enlightened by this therapeutic experience, so we attempted combination therapy using pepleomycin suppositories to supplement intra-cavitary irradiation, for the 11 selected patients who were suffering from uterine fluor. We investigated the treatment results in 7 patients of stage III out of 11 patients (of all stages), in comparison with 13 patients of stage III who were treated by irradiation alone. Consequently, these treatment results were approximately equivalent, and the incidence of sigmoid complications could be decreased. Side effects which were followed by the combination therapy were not serious, and so we believe that pepleomycin suppository is a simple method and valuable to supplement radiation therapy of uterine cervical cancer. (author)

1990-01-01

33

Clinical significance of magnetic resonance imaging (MRI) in evaluation of the extension of uterine cervical cancer  

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Magnetic resonance imaging (MRI) was performed in 62 patients with uterine cervical cancer and the preoperative MRI findings were compared with the pathological findings following surgery. The surgical stages of 62 patients were 2 at stage 0, 18 at stage Ia, 19 at stage Ib, 9 at stage IIa, 11 at stage IIb, 2 at stage IIIa, and 1 at stage IIIb. The MRI findings in the present study included: (1) the existence of a high intensity area (HIA) in the uterine cervix or minimum thickness of residual normal cervical tissue, (2) necrotic cavity, (3) pyometra, (4) irregular margin of the cervix, (5) parametrial invasion, (6) vaginal invasion, (7) bladder invasion, and (8) lymph node enlargement. No HIA was observed in any patient with stage 0 or stage Ia, in 8 patients with stage Ib, and in 2 patients with stage IIa, while all patients with cancer tissues greater than 10 mm in diameter had a HIA. In 39 patients in whom hysterectomy was undergone without conization, the findings of MRI correlated significantly (r=0.929, p<0.001) with the minimum thickness of residual normal cervical tissue by the pathological measurement. When the irregular margin of the cervix was regarded as a disruption of the cervical myo-metrium by cancer tissue, accuracy was 87%. Furthermore, the degrees of accuracy for parametrial invasion, vaginal invasion and bladder invasion were 92%, 90% and 94%, respectively. When lymphnodes greater than 15 mm in diameter were regarded as a positive in MRI, accuracy was 88%. The present results indicate that MRI is clinically effective in preoperatively evaluating the extension of uterine cervical cancer. (author).

Matsubara, Masaru (Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine)

1993-10-01

34

Therapeutic effect of intra-arterial chemotherapy with DDP and 5-FU via bilateral uterine arteries for advanced uterine cervical cancer  

International Nuclear Information System (INIS)

Objective: To evaluate the therapeutic effect of intra-arterial chemotherapy with Ddp and 5-Fu via bilateral uterine arteries for advanced uterine cervical cancer. Methods: During the period of Jan. 2006-Jan. 2009, initial intra-arterial chemotherapy by using a combination of Ddp and 5-Fu via bilateral uterine arteries was performed in 72 patients (mean age 42.9 years) with advanced uterine cervical caner. Of 72 patients, stage I b2 cervical cancer was confirmed in 28, stage II a in 12 and stage II b in 32. Pathologically, cervical squamous cell carcinoma was seen in 56 and cervical adenocarcinoma in 16 patients. Ultrasonography and physical examination were conducted both before and after intra-arterial chemotherapy. The therapeutic results,complications,the surgical resection rate and the pathologic findings were observed and statistically analyzed. Results: Fifty-four patients received one treatment course and 18 patients received two treatment courses. The over all response rate was 77.8%. The response rates of patients with I b2, II a and II b cervical cancer were 92.9%, 83.3% and 62.5% respectively, the difference between three groups was statistically significant (P < 0.05). And the response rates of patients with squamous cell carcinoma and adenocarcinoma were 85.7% and 50.0% respectively, the difference between the two was statistically significant (P < 0.05). The most common side-effects included gastrointestinal symptoms and bone marrow suppression. Thirty-four patients received radical hysterectomy,among them, 22 (78.6%) had stage I b2, 8 (66.7%) had stage II a and 4 (12.5%) had stage II b cervical cancer (P < 0.05). Pathologic exam found no vaginal invasion and ovarian metastasis in all 34 patients. The occurrence of metastasis to lymph nodes and para uterine infiltration were 17.6% and 11.8% respectively. Conclusion: Intra-arterial chemotherapy with a combination of DDP and 5-Fu via bilateral uterine arteries can safely and effectively reduce the tumor volume of advanced cervical cancer, suppress the lymph node metastasis and parametrial infiltration, which is very helpful for creating favorable condition required by the surgery and for reducing the manipulative difficulties of radical hysterectomy. Intra-arterial chemotherapy has better effect on stage Ib2 cervical cancer than on stage II a and II b, and it is quite the same that intraarterial chemotherapy is more effective for cervical squamous cell carcinoma than for adenocarcinoma. (authors)

2010-06-01

35

Computed tomography in staging primary uterine cervical carcinoma  

International Nuclear Information System (INIS)

Pelvic computed tomography (CT) was done in 100 unselected patients with untreated carcinoma of the uterine cervix. The size of the primary tumor, its extension into vagina, parametria, utero-sacral ligaments, pelvic sidewalls, bladder and rectum and pelvic lymphadeonopathy were determined. Independently, similar findings from pelvic examination under general anesthesia (EUA) and cystoscopy were also recorded. International Federation of Gynecology and Obstetrics (FIGO) staging was used for comparison. The staging according to CT in 69 patients (69 percent) agreed with that at EUA and cystoscopy. In 31 patients there was both understaging (15 percent) and over-staging (16 percent) by CT

1983-01-01

36

Computed tomography in staging primary uterine cervical carcinoma  

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Pelvic computed tomography (CT) was done in 100 unselected patients with untreated carcinoma of the uterine cervix. The size of the primary tumor, its extension into vagina, parametria, utero-sacral ligaments, pelvic sidewalls, bladder and rectum and pelvic lymphadeonopathy were determined. Independently, similar findings from pelvic examination under general anesthesia (EUA) and cystoscopy were also recorded. International Federation of Gynecology and Obstetrics (FIGO) staging was used for comparison. The staging according to CT in 69 patients (69 percent) agreed with that at EUA and cystoscopy. In 31 patients there was both understaging (15 percent) and over-staging (16 percent) by CT.

Poon, P.Y. (Princess Margaret Hospital, Toronto, Ontario (Canada))

1983-06-01

37

Value of Lymphography before and after Radical Hysterectomy in Carcinoma of the Uterine Cervic  

International Nuclear Information System (INIS)

Radiological demonstration of lymph vessels and lymph nodes may be achieved only by direct lymphography, which is performed by injecting contrast material directly into the lymph vessels, lymph nodes, or occasionally into lymph cysts. Clinical lymphography is performed essentially according to the direct technique of Kinmonth (1952 and 1954). Lymphography has become a routine procedure in patients with carcinoma of the uterine cervix. Thorough assessment of the extent of carcinoma of the uterine cervix is necessary to the intelligent management of any patient with uterine carcinoma. This presentation is to outline the technique of lymphangio-adenography (lymphography), lymphographic finding and diagnostic criteria of the cervical carcinoma, and evaluation of the accuracy of lymphographic diagnosis in cervical carcinoma. A retrospective review of the lymphograms of 145 patients with carcinoma of the uterine cervix was undertaken. All lymphograms were performed at Kang Nam St. Mary's and St. Mary's Hospitals, Catholic Medical College from 1975 to 1982. Of these patients 87 were got radical hysterectomy and lymphographic diagnosis was compared with tissue pathology of the lymph nodes removed, and determined the diagnostic accuracy of lymphography. Lymphography can make a significant contribution in the pretreatment assessment of patients with carcinoma of the uterine cervix. Strick adherence to rigid criteria will yield excellent pathologic correlation in the event of a positive radiographic diagnosis of metastatic carcinoma. Once a positive diagnosis is made, it should influence the management of the cancer patients. The results were as follow: 1. The accuracy of lymphography in diagnosing lymph node matastasis of carcinoma of the uterine cervix was 85.1%, 82.4% in sensitivity and 86.8% in specificity. 2. Metastic lymph nodes were moderately to markedly enlarged and irregular in shape and shown motheaten marginal filling defects in 92.7%. These were ranged from 3mm to 20mm in the greatest diameter. 3. Metastatic lymph nodes showed a tendency to get increased in size, in proportion to the size of marginal filling defect. 4. The size of filling defect of metastatic lymph nodes was not correlated to the clinical stage of carcinoma of the uterine cervix. 5. Lymph node metastasis was confirmed in 6 patients of 10 patients who were got lymphography in 2 to 5 years after radical hysterectomy. 6. Many collateral lymphatics and lymphatic cysts were found out in the lymphography after radical hysterectomy in carcinoma of the uterine cervix.

1983-09-01

38

Value of Lymphography before and after Radical Hysterectomy in Carcinoma of the Uterine Cervic  

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Radiological demonstration of lymph vessels and lymph nodes may be achieved only by direct lymphography, which is performed by injecting contrast material directly into the lymph vessels, lymph nodes, or occasionally into lymph cysts. Clinical lymphography is performed essentially according to the direct technique of Kinmonth (1952 and 1954). Lymphography has become a routine procedure in patients with carcinoma of the uterine cervix. Thorough assessment of the extent of carcinoma of the uterine cervix is necessary to the intelligent management of any patient with uterine carcinoma. This presentation is to outline the technique of lymphangio-adenography (lymphography), lymphographic finding and diagnostic criteria of the cervical carcinoma, and evaluation of the accuracy of lymphographic diagnosis in cervical carcinoma. A retrospective review of the lymphograms of 145 patients with carcinoma of the uterine cervix was undertaken. All lymphograms were performed at Kang Nam St. Mary's and St. Mary's Hospitals, Catholic Medical College from 1975 to 1982. Of these patients 87 were got radical hysterectomy and lymphographic diagnosis was compared with tissue pathology of the lymph nodes removed, and determined the diagnostic accuracy of lymphography. Lymphography can make a significant contribution in the pretreatment assessment of patients with carcinoma of the uterine cervix. Strick adherence to rigid criteria will yield excellent pathologic correlation in the event of a positive radiographic diagnosis of metastatic carcinoma. Once a positive diagnosis is made, it should influence the management of the cancer patients. The results were as follow: 1. The accuracy of lymphography in diagnosing lymph node matastasis of carcinoma of the uterine cervix was 85.1%, 82.4% in sensitivity and 86.8% in specificity. 2. Metastic lymph nodes were moderately to markedly enlarged and irregular in shape and shown motheaten marginal filling defects in 92.7%. These were ranged from 3mm to 20mm in the greatest diameter. 3. Metastatic lymph nodes showed a tendency to get increased in size, in proportion to the size of marginal filling defect. 4. The size of filling defect of metastatic lymph nodes was not correlated to the clinical stage of carcinoma of the uterine cervix. 5. Lymph node metastasis was confirmed in 6 patients of 10 patients who were got lymphography in 2 to 5 years after radical hysterectomy. 6. Many collateral lymphatics and lymphatic cysts were found out in the lymphography after radical hysterectomy in carcinoma of the uterine cervix.

Kim, Choon Yul; Oh, Yung Ho; Yang, Woo Jin; Bahk, Yong Whee [Catholic Medical College, Seoul (Korea, Republic of)

1983-09-15

39

Apparent diffusion coefficient in cervical cancer of the uterus: comparison with the normal uterine cervix  

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A relation between apparent diffusion coefficient (ADC) values and tumor cellular density has been reported. The purpose of this study was to measure the ADC values of cervical cancers in the uterus and compare them with those of normal cervical tissues, and to test whether ADC could differentiate between normal and malignant cervical tissues in the uterus. Twelve consecutive female patients with cervical cancer of the uterus and ten female patients with other pelvic abnormalities were included in this study. ADC was measured at 1.5 T with b-factors of 0, 300 and 600 s/mm{sup 2} using single-shot echo-planar diffusion-weighted imaging and a parallel imaging technique. The mean ADC value of cervical cancer lesions was 1.09{+-}0.20 x 10{sup -3} mm{sup 2}/s, and that of normal cervix tissue was 1.79{+-}0.24 x 10{sup -3} mm{sup 2}/s (P<0.0001). In nine patients treated by chemotherapy and/or radiation therapy, the mean ADC value of the cervical cancer lesion increased significantly after therapy (P<0.001). The present study showed, with a small number of patients, that ADC measurement has a potential ability to differentiate between normal and cancerous tissue in the uterine cervix. Further study is necessary to determine the accuracy of ADC measurement in monitoring the treatment response. (orig.)

Naganawa, Shinji; Sato, Chiho; Ishigaki, Takeo [Nagoya University School of Medicine, Department of Radiology, Nagoya (Japan); Kumada, Hisashi; Miura, Shunichi [Toyohashi Municipal hospital, Department of Radiology, Toyohashi, Aich (Japan); Takizawa, Osamu [Siemens-Asahi Medical Technologies Ltd, Tokyo (Japan)

2005-01-01

40

Pelvic insufficiency fracture after definitive radiotherapy for uterine cervical cancer. Retrospective analysis of risk factors  

International Nuclear Information System (INIS)

The purpose of this study is to determine the incidence, clinical characteristics and risk factors of postradiation pelvic insufficiency fracture (PIF) in women with uterine cervical cancer. We reviewed the medical records of 126 patients who received definitive radiotherapy (RT) for uterine cervical cancer between 2003 and 2009 at our institution. Among them, 99 patients who underwent at least one computed tomography (CT) or magnetic resonance imaging of the pelvis during their follow-up at more than 6 months were included in this analysis. The relationship between the incidence of PIF and several patient- and treatment-related factors was analyzed. The median follow-up period was 21 months. Of the 126 patients, 33 (with a total of 50 lesions) were diagnosed with PIF. The 2-year cumulative incidence was 32%. Univariate analysis showed that age ?70 years (P= 0.0010), postmenopausal state (P = 0.0013), and lower CT density of bone and bone marrow (P = 0.020) significantly related to PIF. In a multivariate analysis, of the 59 patients whose CT densities were evaluable, lower CT density was the only significant factor associated with PIF (P = 0.0026). In conclusion, postradiation PIFs were detected in a considerable number of patients after definitive RT for cervical cancer. Predisposing factors were older age, postmenopausal state, and decreased density of bone and bone marrow on CT. (author)

2013-11-01

 
 
 
 
41

Lumboaortic irradiation in uterine cervical cancer: Analysis of the literature  

International Nuclear Information System (INIS)

Background: Uterine cancer is a prevalent disease in Chile and it is one of the most frequent cancer locations treated in the National Chilean Cancer Institute. It is also common to receive young patients that have advanced tumors in stages IIB and IIIB with high risks of compromises of lymphatic nodes of pelvis and aortic-lumbar zones. The treatment for these kinds of cancers is radio-chemotherapy. Aims: Determinate if the radiotherapy of aortic-lumbar lymph nodes lowers the chance of relapsing or increase the survival rate in patients with evident compromise of aortic-lumbar lymph nodes and in those with high risk of compromise in that level. Method: Exhaustive analysis of the literature about the indication of radiotherapy of aortic-lumbar lymph nodes in cervix cancer which is classified in those where the radiotherapy treatment is done in patients with evident compromise of aortic-lumbar lymph-nodes, and those where de radiotherapy is done in patients with high risk of compromise in that level. Results: In patients with small cervix tumors and positive lymphoid nodes the LA lymphatic nodes treatment would be beneficial. However, patients that suffer massive pelvic disease (IIIB) or that have evidence of the disease, the benefit would not be so important. Conclusion: Patients with controllable pelvic disease and with high risk of having aortic-lumbar lymph nodes compromise are the most benefit of radiotherapy in aortic-lumbar lymph nodes (stages IA-B, IIA-B with positive lymph nodes)

2010-01-01

42

Problems on the treatment of the uterine cervical cancer  

International Nuclear Information System (INIS)

The 5 year survival rate of cervical cancer in Japan is 86% in Stage I, 67% in stage II, 37% in Stage III, and 12% in Stage IV separately. In the early cancer as Stage 0 and Stage Ia even 100% and 93% survival rates can be achieved, so in this group, reduction operation for function reservation is recommended. On the other hand in the advanced cancer, the result of the treatment is unsatisfied yet, and better therapy must be considered. This report discuss the effect and the limit of operation therapy and postoperative radiotherapy, as well as the prognosis and side-effect of the radiotherpy in the viewpoint of the doses. (author)

1982-01-01

43

An analysis of prognostic factors in the uterine cervical cancer patients  

International Nuclear Information System (INIS)

The aim of this study is to analysis of survival and recurrence rates of the uterine cervical carcinoma patients whom received the radiation therapy respectively. The prognostic factors, such as Papanicolaou (Pap) smear, carcinoembriogenic antigen (CEA) and squamous cell carcinoma (SCC) antigen has been studied. From January 1981 to December 1998, eight-hundred twenty-seven uterine cervical cancer patients were treated with radiation therapy. All of the patients were divided into two groups: the radiation therapy only (521 patients) group and the postoperative radiation therapy (326 patients) group. The age, treatment modality, clinical stage, histopathology, recurrence, follow-up Pap smears, CEA and see antigen were used as parameters for the evaluation. The prognostic factors such as survival and recurrence rates were performed with the Kaplan-Meier method and the Cox hazard model, respectively. Median fallow-up was 38.6 months. On the radiation therapy only group, 314 patients (60%) achieved complete response (CR), 47 patients (9%) showed local recurrence (LR), 78 patients (15%) developed distant metastasis (DM). On the postoperative radiation therapy group, showed 276 patients (85%) CR, 8 patients (2%) LR, 37 patients (11%) DM. The 5-year survival and recurrence rates was evaluated for all parameters. The statistically significant factors for the survival rate in univariate analysis were clinical stage (p=0.00001), treatment modality (p=0.0010), recurrence (p=0.0001), Pap smear (p=0.0329), CEA (p=0.0001) and SCC antigen (p=0.0001). This study indicated that after treatment, the follow-up studies of Pap smear, CEA and SCC antigen were significant parameter and prediction factors for the survival and recurrence of the uterine cervical carcinoma

2000-12-01

44

Results of Radiotherapy for the Uterine Cervical Cancer  

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One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIGO including physical examination, pelvic examination, cystoscopy, rectosigmoidoscopy, chest X-ray, IVP, Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; In case of radiation therapy only, whole pelvic irradiation was given with C0-69 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cGy per day, 5 days per week and intracavitary insertion was performed. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. Local control rate of tumor according to the size was 91.3% for less than 5 cm in size and 44.6% in tumor over 5 cm (p<0.0068). Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the papa-aortic lymph nodes were the most common site for distant metastases. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. The 5-year survival rates showed; stage la and lb 95%, stage lla 81% stage llb 67%, stage llla 37.7%, stage lllb 23%, and 3-year survival rate of stage lVa showed 11.6%, retrospectively.

Kim, Chul Yong; Choi, Myung Sun; Suh, Won Hyuck [Korea University College of Medicine, Seoul (Korea, Republic of)

1988-06-15

45

Results of Radiotherapy for the Uterine Cervical Cancer  

International Nuclear Information System (INIS)

One hundred fifty-four patients with the carcinoma of the uterine cervix were studied retrospectively to assess the result and impact of treatment at Department of Radiation Oncology, Korea University, Hae-Wha Hospital from Feb 1981 through Dec. 1986. Prior to radiotherapy, the patients were evaluated and staged by recommendation of FIGO including physical examination, pelvic examination, cystoscopy, rectosigmoidoscopy, chest X-ray, IVP, Ba enema. Also, an additional pelvic CT scan was obtained for some of the patients. The patients were treated by radiotherapy alone or adjuvant postoperative irradiation; In case of radiation therapy only, whole pelvic irradiation was given with C0-69 teletherapy unit via AP and PA parallel opposing fields or 4-oblique fields, 180 cGy per day, 5 days per week and intracavitary insertion was performed. Three dimensional quantitative demonstration of tumor volume is also important in planning radiation therapy. Another advantage of CT scan was detection of recurrent tumor after radiation or surgery. Local control rate of tumor according to the size was 91.3% for less than 5 cm in size and 44.6% in tumor over 5 cm (p<0.0068). Thirty out of 50 recurrent sites has locoregional failures and 17 cases has distant metastases. And the papa-aortic lymph nodes were the most common site for distant metastases. The most common complication was temporal rectal bleeding which was controlled most by conservative management. However, 4 patients required for endoscopic cauterization. The 5-year survival rates showed; stage la and lb 95%, stage lla 81% stage llb 67%, stage llla 37.7%, stage lllb 23%, and 3-year survival rate of stage lVa showed 11.6%, retrospectively

1988-06-01

46

Treatment Planning Software for High Dose Rate Remote Afterloading Brachytherapy of Uterine Cervical Cancer  

International Nuclear Information System (INIS)

In brachytherapy of uterine cervical cancer using the high dose rate remote afterloading system, it is of prime importance to determine the position of the radiation sources and to estimate the irradiation time. However, calculation with manual method is so time consuming and laborious, that authors designed a software as an aid to intracavitary radiotherapy planning using the personal computer to obtain the precision of treatment without being too complicated for routine use. Optimal source arrangement in combination with dose rate at each specific points and irradiation time can be easily determined using this software in several minutes

1986-12-01

47

Usefulness of tumor size on MR imaging in assessing the prognosis of uterine cervical cancer treated with radiation  

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The purpose of this study was to assess the usefulness of MR imaging (MRI) in evaluating the primary tumor and predicting the prognosis after radiotherapy for uterine cervical carcinoma. MRI was performed before radiotherapy in 25 patients with squamous cell carcinoma. According to the staging of FIGO, 3 patients were classified as stage Ib, 1 as IIa, 5 as IIb, 13 as IIIb, 2 as IVa, and 1 as IVb. Three-dimensional diameters (transverse, anteroposterior, and craniocaudal) of the primary tumor were evaluated on T2-weighted images. For patients with tumors {<=}4 cm in craniocaudal diameter, i.e., the length of the tumor parallel to the long axis of uterine body, five-year disease-free survival (DFS) was 70%. For patients with tumors >4 cm in craniocaudal diameter, the 5-year DFS was 37%. The difference between the two groups was statistically significant. For patients with tumors {<=}4 cm and >4 cm in transverse or anteroposterior diameter, 5-year DFS was 63% and 50% respectively. There was no statistically significant difference between the two groups. The results showed the craniocaudal diameter of the tumor to be the most critical factor in predicting prognosis after radiation therapy in uterine cervical cancer. Moreover, MRI was an important means of evaluating the depth of uterine cervical carcinoma. In conclusion, MRI is useful in evaluating the effect of radiotherapy and predicting prognosis in uterine cervical cancer. (author)

Hayashi, Toshihiko; Kato, Tomoyasu [Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital

1999-05-01

48

Usage of CT and tumor markers in the management of a patient with cervical cancer after colpocleisis for uterine prolapse  

International Nuclear Information System (INIS)

A 79-year-old woman developed stage IIIb cervical carcinoma 13 years after colpocleisis for uterine prolapse. The patient was treated with external irradiation of 60 Gy and chemotherapy with 5-FU (100 mg/day) and Ok-432. The response of tumor could be monitored by serial changes in tumor markers, such as SCC, IAP, TPA, CEA, LDH, and ALP, and CT findings. Considering that colpocleisis makes it impossible to visualize the uterine cervix, the adequate selection of surgical procedure for uterine prolapse is required. (Namekawa, K.)

1986-01-01

49

Results of radiation therapy for uterine cervical cancer using high dose rate remote after loading system  

International Nuclear Information System (INIS)

In Japan, radiotherapy with high dose rate remote after loading system (HDR-RALS) for intracavitary brachytherapy is the standard treatment for more than 30 years. This report showed the usefulness of HDR-RALS for uterine cervical cancer. From 1980 through 1999, 442 patients with uterine cervical cancers (stage I: 66, stage II: 161, stage III: 165, stage IV: 50) were treated. Radiotherapy was performed both external teletherapy and HDR-RALS. Overall survival rate at 5 years was 60.2%. The 5-year actuarial incidence of all complications was 16.4%. The 5-year actuarial incidence of all complications in cases treated with the sum doses of whole pelvic irradiation (without central shield) and RALS up to 49 Gy, 50 to 59 Gy or larger doses were 7.5%, 11.0% and 25.2%, respectively. Radiation therapy using HDR-RALS was very effective. While the dose of whole pelvic irradiation was increased, the actuarial incidence of all complications was increased. (author)

2003-04-01

50

CT and ultra low field (0.02 T) MR imaging of uterine cervical carcinoma  

International Nuclear Information System (INIS)

Nineteen pelvic MR and 21 CT examinations were performed in 21 patients with uterine cervical carcinoma. The results were compared with clinical (FIGO) staging in all patients, and with the histopathologic results after operation in 8. In the evaluation of local tumor growth CT agreed with clinical staging in 29%, MR imaging with clinical staging in 47% and CT with MR in 53%. The greatest discrepancy between the imaging methods and clinical examination was in the evaluation of parametrial extension. From 8 Stage I tumors with surgical confirmation the local tumor growth was overestimated with CT in 3 cases, with clinical examination in 2 and with MR imaging in 2 cases. CT and MR imaging at 0.02 T did not differ in the evaluation of parametrial tumor growth. Clinical examination overestimated parametrial growth but was relatively accurate in detecting vaginal wall involvement. MR imaging at 0.02 T is a convenient, inexpensive and accurate method for the local staging of early uterine cervical carcinoma. (orig.)

1994-07-01

51

The treatment of Uterine Cervical Cancer Using High Dose Rate Co-60 Sources  

International Nuclear Information System (INIS)

The radical treatment of uterine cervical cancer by intracavitary radium or cesium, in combination with teletherapy are well known. Although the result of such treatment should not give rise to complacency, problem of radiation exposure to medical staff had not been resolved. Fortunately, many attempts have been made to reduce this hazard, most of which take the form of afterloading applicators with a suitably shielded radioisotope. In order to avoid hazardous radiation exposure to staffs concerned with brachytherapy, RALS using high intensity source of Co-60, have been employed at Yonsei Cancer Center since May, 1979. It allows rectal and bladder doses to be kept low, while maintaining a satisfactory usual dose distribution of the other type of applicators, and the short treatment time allow four or five patients to be treated per hour. It also removes much patient's discomfort and the difficulties of nursing these patients. Since the first introduction in Korea, over seven hundred cases with various stage of uterine cervical cancer have been treated on a radical basis at this center last 4 years. These authors have strongly attracted attention to the results in terms of local control rate, survival s and morbidity compared with those of conventional low dose rate radiotherapy. Retrospective interim analysis of data was preliminarily accomplished through the labored follow-up study of 340 cases treated during initial 2 years and the radiobiological standpoint of high dose rate intracavitary irradiation will be discussed

1983-06-01

52

Effect of strong Posterisan ointment on rectal injuries after radiotherapy of uterine cervical cancer  

International Nuclear Information System (INIS)

In order to reduce the rectal injuries in the patients that received telecobalt irradiation after radical operation of uterine cervical cancer, strong posterisan ointment was employed. The ointment, composed of 0.16259 ml of death E. coli suspension, 2.5 mg of hydrocortisone and 4.98 mg of phenol per 1 gram, was given in 2 grams at one dose 2 to 3 time a day for 2 to 35 days according to severity of the symptoms. 60Co irradiation was performed in 150 to 200 rads 5 times a week. A total dose reached 4000 to 6000 rads, and the most patients were given 5000 rads. Of 9 patients, in whom the drug was given before and simultaneously with the onset of radiotherapy, irradiation was completed in 3 patients without any symptoms during radiotherapy. It suggested that the drug had a preventive effect on rectal injuries. Of 47 patients, in whom some symptoms were observed, the drug was effective in 30 patients, slightly effective in 8 and ineffective in 9, with the effective rate of 80.9 per cents. It was revealed that the drug was effective to the treatment of rectal injuries in radiotherapy of uterine cervical cancer. (Kumagai, S.)

1977-01-01

53

Radiotherapy of Uterine Cervical Cancer Using Fletcher-Suit-Delclos Cesium Applicator  

International Nuclear Information System (INIS)

From Nov. 1983 through Feb. 1986, 35 patients of uterine cervical cancer were treated by external radiation therapy and intracavitary radiation therapy using Fletcher-Sult-Delclos applicator. Age of the patients ranged from 32 to 70 years (median age:53 years). All patients had follow up from 9 to 34 months and median follow up of 20 months. 4 patients were in stage I, 25 were in stage II, 5 were in stage III and I was in stage IV. Overall regression rate was 80% and uncorrected actuarial 2 year survival rate was 88%. The incidence of rectal complications were analyzed. There was no rectal complication in the patients who received less than 7000 rad maximal rectal dose, but 2 out of 17 patients who received more than 7000rad developed moderate degree (grade 2) of rectal complication. In viewing of our results, Fletcher-Suit-Delclos applicator (3M) seemed to be an appropriate instrument for intracavitary radiation therapy in the patients of uterine cervical cancer

1986-12-01

54

Radiotherapy of Uterine Cervical Cancer Using Fletcher-Suit-Delclos Cesium Applicator  

Energy Technology Data Exchange (ETDEWEB)

From Nov. 1983 through Feb. 1986, 35 patients of uterine cervical cancer were treated by external radiation therapy and intracavitary radiation therapy using Fletcher-Sult-Delclos applicator. Age of the patients ranged from 32 to 70 years (median age:53 years). All patients had follow up from 9 to 34 months and median follow up of 20 months. 4 patients were in stage I, 25 were in stage II, 5 were in stage III and I was in stage IV. Overall regression rate was 80% and uncorrected actuarial 2 year survival rate was 88%. The incidence of rectal complications were analyzed. There was no rectal complication in the patients who received less than 7000 rad maximal rectal dose, but 2 out of 17 patients who received more than 7000rad developed moderate degree (grade 2) of rectal complication. In viewing of our results, Fletcher-Suit-Delclos applicator (3M) seemed to be an appropriate instrument for intracavitary radiation therapy in the patients of uterine cervical cancer.

Sohn, Seung Chang; Yoon, Jong Chul; Suh, Hyun Suk [Seoul Paik Hospital, Seoul (Korea, Republic of)

1986-12-15

55

Analysis of radiotherapy in Kumamoto National Hospital. 2. Clinical study on radiotherapy and survival rate of the uterine cervical carcinoma  

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From 1967 to 1985, 1078 patients with gynecological neoplasms were treated by radiotherapy in our hospital, and 922 cases of them were uterine cervical carcinoma, 40 cases were endometrial carcinoma, 56 cases were ovarial cancer and 60 cases were other cancer. Of these 922 patients with uterine cervical carcinoma, 683 patients were treated by irradiation alone and another 239 patients were treated by postoperative irradiation. The results of radiotherapy for uterine cervical carcinoma from 1961 to 1979 were analyzed. The five-year survival rate from 1961 to 1966 with deep x-ray therapy were 23%, and from 1967 to 1979 with /sup 60/Co unit were 44%. By improvement of methods of radiotherapy, the five-year survival rate during the period of 1975 to 1979 (54%) became higher than that during the period of 1967 to 1974 (37%). The survival rate in the postoperative group during the period of 1975 to 1979 was approximately 20% higher than the that during the period of 1967 to 1974. The effect of radiotherapy was dependent on the therapeutical equipment and methods of treatment in our hospital. Starting from 1981, radiotherapy for uterine cervical carcinoma has been using linear accelerator and /sup 60/Co remote afterloading system.

Fujimura, Noriharu; Sakamoto, Yuji; Matsuyama, Shigemaro; Tokunaga, Tatsuya; Mimori, Hiroyuki

1987-02-01

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Prognostic value of podoplanin expression in intratumoral stroma and neoplastic cells of uterine cervical carcinomas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To investigate the clinicopathological significance of podoplanin expression in the intratumoral stroma and neoplastic cells of early stage uterine cervical cancer. MATERIALS AND METHODS: A total of 143 patients with clinical stage I and IIA uterine cervical carcinomas underwent surgery b [...] etween 2000 and 2007. Clinicopathological data and slides associated with these cases were retrospectively reviewed. Immunodetection of podoplanin expression in histologic sections of tissue microarray blocks was performed using the monoclonal antibody D2-40. RESULTS: Expression of podoplanin was detected in neoplastic cells in 31/143 (21.6%) cases, with 29/31 (93.5%) of these cases diagnosed as squamous carcinoma. For all of the cases examined, the strongest signal for podoplanin expression was observed at the proliferating edge of the tumor nests. The rate of positive podoplanin expression for node-positive cases was lower than that of node-negative (18.9% vs. 22.6%, respectively). Furthermore, the rate of positive podoplanin expression in fatal cases was 10.5% vs. 21.6%, respectively. In 27/143 (18.8%) cases, podoplanin expression was detected in fibroblasts of the intratumoral stroma, and this expression did not correlate with patient age, clinical stage, tumor size, histologic type, depth of infiltration, or vascular involvement. Moreover, expression of podoplanin in intratumoral stroma fibroblasts was only negatively associated with nodal metastasis. A greater number of fatal cases was observed among negative intratumoral stroma fibroblasts (15.5% vs. 3.7%, respectively), although this difference was not significant. CONCLUSIONS: These preliminary results suggest that podoplanin may have a role in host-tumor interactions and, as a result, may represent a favorable prognostic factor for squamous cervical carcinomas.

Carvalho, Filomena M; Zaganelli, Fabricia L; Almeida, Bernardo G L; Goes, Joao Carlos Sampaio; Baracat, Edmund C; Carvalho, Jesus P.

57

Protein profiling underscores immunological functions of uterine cervical mucus plug in human pregnancy  

DEFF Research Database (Denmark)

The cervical mucus plug (CMP) differs from the cervical secretions of non-pregnant women, and is the ultimate sealant of the uterine cavity during pregnancy. Although several studies have analyzed biochemical properties of large glycoproteins in the CMP, comprehensive information about its protein composition is yet unavailable. We hypothesized that protein profiling of the CMP could provide key clues to its physiological functions in pregnancy. For this purpose, five CMPs obtained from women in labor at term were analyzed by LC-MS/MS. Out of 291 total proteins identified, 137 were detected in two or more samples, which included S100A8, S100A9, and complement proteins (C3, C4a, C4b, C6, and C8g). Several proteins, which have not been described in the cervical mucus of non-pregnant women or in cervicovaginal fluids, such as CD81 antigen and pregnancy zone protein, were also identified. Gene ontology analysis of identified proteins showed significant enrichment of 28 biological processes such as 'activation of plasma proteins involved in acute inflammatory response' and 'positive regulation of cholesterol esterification'. We report the proteome of CMPs from pregnant women at term for the first time, and the overall findings strongly suggest an important role for the CMP in the maintenance of pregnancy and parturition.

Lee, Deug-Chan; Hassan, Sonia S

2011-01-01

58

Case Report: Uterine Adenocarcinoma Metastasis to the Skull Base and Cervical Spine Presenting with Pathological Fracture and Myelopathy  

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Full Text Available Objective: The authors report a rare case of uterine adenocarcinoma metastasis to both the skull base and cervical spine presenting with pathological fracture and myelopathy. Methods: We report the case of a 43-year-old Asian female with widely metastatic uterine adenocarcinoma who over the course of 3 years was diagnosed with a large clival mass and more recently a cervical spine pathological fracture presenting with myelopathy. Results: This patient underwent multiple procedures over a three-year period, including total hysterectomy with tumor debulking, endonasal biopsy of clival mass and most recently cervical corpectomy and fusion. She has received chemotherapy and radiation therapy for treatment of the unresectable clival mass and has done quite well despite having this pathology. Conclusion: This is the first documented case of clival involvement of endometrial adenocarcinoma. Additionally, this is a unique case of spinal metastatic endometrial adenocarcinoma presenting with pathological fracture and myelopathy.

Paul E. Kaloostian

2013-07-01

59

Comparison of single-, double- and triple-combined testing, including Pap test, HPV DNA test and cervicography, as screening methods for the detection of uterine cervical cancer.  

Science.gov (United States)

Cervical cancer is a serious disease that threatens the health of women worldwide. This study compared the sensitivities and false-positive rates of cervical cytology (Pap smear), human papilloma virus (HPV) DNA test, cervicography, first double-combined testing (cervical cytology and HPV DNA test), second double-combined testing (cervical cytology and cervicography) and triple-combined testing (cervical cytology, HPV DNA test and cervicography). The study included 261 patients screened for uterine cervical cancer. All women simultaneously underwent cervical cytology, HPV DNA test and cervicography for uterine cervical cancer screening and colposcopically directed biopsy for diagnostic evaluation. The triple-combined testing was consistently the most sensitive among the cervical screening tests. The second double-combined testing, with a sensitivity rate of 98.1% was more sensitive than the first double-combined test (92.3%). However, cervical cytology was most specific (93.5%) and showed the highest positive predictive value (77.8%). The sensitivity of cervical cytology was markedly improved in combination with HPV DNA test and cervicography. Thus, the triple-combined testing, which improves the high false negativity of cervical cytology, may be an effective tool in uterine cervical cancer screening, pending confirmation of the effectiveness in a mass screening study. PMID:23443346

Kim, Ju Hee; Kim, In-Wook; Kim, Yong-Wan; Park, Dong Chun; Kim, Yong Wook; Lee, Keun-Ho; Ahn, Tae-Gyu; Han, Sei-Jun; Ahn, Woong Shick

2013-04-01

60

Clinical significations of G2-M stage partial synchronization on radiation therapies of uterine cervical carcinomas  

International Nuclear Information System (INIS)

The present study revealed that irradiation-induced changes of repopulation and redistribution played an important role in radiosensitivity and cure process of human uterine cervical carcinoma. DNA measurements by a microspectrophotometer were made on Feulgen stained biopsy specimens obtained from 20 patients. On the other hand, flow-microfluorometric measurements with Fried's computed cell cycle analysis were made on transplanted human cervical carcinomas. The mean nuclear DNA amount of human cervical carcinoma cells increased according as the irradiation doses increase until 2,000 rad. Moreover, as regards with the mean nuclear diameter of cancer cells the same phenomenon was recognized, and there was an interrelation between the increase of mean nuclear DNA amount and that of mean nuclear diameter. This phenomenon was proved in nuclear DNA analysis by flow-microfluorometric measurements on transplanted human cervical carcinoma in nude mice. Computed cell cycle analysis of F.M.F. data demonstrated that this phenomenon was due to irradiation-induced changes of repopulation and redistribution. That is to say, irradiation induces the increase of cycling cells and then partial synchronization to G2-M stage. Examination of the interrelation between this phenomenon at 500 rad and 5 years survival rate demonstrated that there was more increase of nuclear DNA amount in the good prognosis group than in the poor prognosis group. Estimation of residual cells near the G1 stage at 2,000 rad demonstrated that there were more residual cells near the G1 stage in the poor prognosis group than in the good prognosis group. (author)

1981-01-01

 
 
 
 
61

Assessment of the natural course and treatment of premalignant uterine cervical lesions in pregnancy  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. Premalignant changes of the uterine cervix occur with similar frequency during pregnancy and in non­pregnant women. Due to the fact that any surgery on the cervix can jeopardize pregnancy, it is important to define the protocol of procedures for the treatment of these changes during pregnancy. Objective. The aim of the study was to investigate the natural course of premalignant cervical changes during pregnancy and the impact of their treatment on the pregnancy course. Methods. Study involved all patients with colposcopically, cytologically and hystopathologically diagnosed premalignant cervical changes during pregnancy from 2002 to 2008. Patients were divided into two groups according to the applied treatment during pregnancy: surgery or monitoring by regular colposcopic and cytological examinations. The two groups were compared concerning treatment outcome, persistence or regression of changes and pregnancy duration. Results. Study involved 58 patients. Spontaneous remission of lesions occurred after pregnancy in 63.79% of cases. Highgrade squamous intraepithelial lesion (H­SIL demonstrated a higher rate of persistency in comparison with low­grade squamous intraepithelial lesion (L­SIL (?2=25.115; p<0.05. Only one finding of L­SIL progressed into H­SIL in the monitored group. Patients who underwent conization during pregnancy had a significantly more frequent preterm deliveries (?2=14.369; p<0.05. Conclusion. The obtained high rate of spontaneous regression of cervical changes after pregnancy as well as the lower incidence of preterm births in patients who were not treated by conization during pregnancy, confirm that patients with premalignant cervical changes should be, if invasion is excluded, under follow­up throughout pregnancy by regular colposcopic and cytological examinations. Therapeutic conization, due to numerous complications, should be performed only when there is a suspected presence of a more severe form of the disease (micro invasive and invasive carcinoma.

Šljivan?anin Dragiša

2013-01-01

62

Evaluation by MR imaging of neoadjuvant intra-arterial infusion chemotherapy in uterine cervical cancer  

International Nuclear Information System (INIS)

Eight patients with uterine cervical cancer received two or three courses of neoadjuvant chemotherapy, including 254-S iv. and CDDP ia. Transcatheter arterial embolization (TAE) was added for seven patients. The therapeutic efficacy was evaluated by MR imaging and postoperative histopathological examination. Three patients achieved a complete response (CR) and five others were evaluated as a partial response (PR) on MR imaging. On postoperative histology, three of eight showed CR or PR, which coincided with MR findings. Viable cancer cells were shown in five patients. To detect these viable tumors, dynamic MR imaging was indispensable. However, because of limited spatial resolution, the detection of small residual tumors was not easy using dynamic MR imaging. (author)

1998-07-01

63

Reproducibility of Applicator Position with High dose rate brachytherapy in uterine cervical cancer  

Energy Technology Data Exchange (ETDEWEB)

Brachytherapy is the main component in treatment of patients with uterine cervical cancer. The reproducibility of applicator position in the same patient at repeated treatments was very important for accurate dose delivery. It was aimed to evaluate the change of applicator location between each high dose rate(HDR) brachytherapy insertion in the patients with uterine cervical cancer. From January 1999 to October 2001, total 52 patients were treated with external beam radiotherapy and HDR brachytherapy (Microselectron, Nucletron). During six to seven times of brachytherapy, all patients had three treatment plans. From the orthogonal radiographs, we measured the following variables; height from upper border of pubic bone to os (HPO), distance from sacral promontory to tip of tandem (DST), distance from coccyx to os (DCO), distance from tip of right ovoid to os (DRO), distance from tip of left ovoid to os (DLO), and distance from center of the first tandem source to ovoid (DTO). To evaluate the reproducibility of applicator position, it was calculated the standard deviation of differences between three insertions for the 7 parameters in each patient.The ranges of standard deviations of interfractional differences for the variables were as follows. 1)HPO: 0-0.79 cm 2)DST: 0-0.9 cm 3)DCO: 0.06-0.76 cm 4)DRO: 0-0.53 cm 5)DLO: 0-0.45 cm 6)DTO; 0-0.36 cm There was some change in applicator position on repeated implants in our study. But variation of the interfractional differences was minimal; in all parameters, there were less than 1 cm. We are continued to try for reducing the geometric variation between each procedure.

Kim, Jong Hwa; Son, Jung Hae; Jung, Chul; Kim, Mi Hwa [Dept. of Radiation Oncology, Ajou University Hospital, Suwon (Korea, Republic of)

2003-09-15

64

Reproducibility of Applicator Position with High dose rate brachytherapy in uterine cervical cancer  

International Nuclear Information System (INIS)

Brachytherapy is the main component in treatment of patients with uterine cervical cancer. The reproducibility of applicator position in the same patient at repeated treatments was very important for accurate dose delivery. It was aimed to evaluate the change of applicator location between each high dose rate(HDR) brachytherapy insertion in the patients with uterine cervical cancer. From January 1999 to October 2001, total 52 patients were treated with external beam radiotherapy and HDR brachytherapy (Microselectron, Nucletron). During six to seven times of brachytherapy, all patients had three treatment plans. From the orthogonal radiographs, we measured the following variables; height from upper border of pubic bone to os (HPO), distance from sacral promontory to tip of tandem (DST), distance from coccyx to os (DCO), distance from tip of right ovoid to os (DRO), distance from tip of left ovoid to os (DLO), and distance from center of the first tandem source to ovoid (DTO). To evaluate the reproducibility of applicator position, it was calculated the standard deviation of differences between three insertions for the 7 parameters in each patient.The ranges of standard deviations of interfractional differences for the variables were as follows. 1)HPO: 0-0.79 cm 2)DST: 0-0.9 cm 3)DCO: 0.06-0.76 cm 4)DRO: 0-0.53 cm 5)DLO: 0-0.45 cm 6)DTO; 0-0.36 cm There was some change in applicator position on repeated implants in our study. But variation of the interfractional differences was minimal; in all parameters, there were less than 1 cm. We are continued to try for reducing the geometric variation between each procedure.

2003-09-01

65

Squamous cell carcinoma antigen in serum for monitoring of head and neck and uterine cervical squamous cell carcinomas after radiotherapy  

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Squamous cell carcinoma antigen (SCC-A) in serum was serially measured during follow-up of 96 squamous cell carcinoma patients (75 head and neck cancers and 21 uterine cervical cancers), treated with radiotherapy. In 27 of the patients with head and neck cancer and in 12 of those with cervical cancer SCC-A had also been measured before radiotherapy. In this head and neck carcinoma group, the median level of SCC-A was 1.3 (95% CI: 1.2-1.9) ng/ml before radiotherapy and 1.4 (CI: 1.1-1.5) ng/ml after radiotherapy. In the cervical carcinoma group, the median SCC-A decreased significantly (p<0.001) from a pretreatment value of 7.5 (CI: 3.8-26.3) ng/ml to a posttreatment value of 0.9 (CI:<0.5-1.8) ng/ml. In the total group of 75 head and neck cancers 21 relapses occurred and in 4 of these the relapse was detected at a clinically silent stage by an elevation of serum SCC-A. The same was true for 4 of the 9 relapses that occurred in the total group of uterine cervical cancer. The study suggests that serum SCC-A may be useful for posttreatment monitoring of patients with uterine cervix cancer while its value in head and neck cancer probably is more marginal. (orig.).

Shirato, Hiroki (Dept. of Therapeutic and Diagnostic Radiology, Obihiro Kohsei Hospital (Japan)); Ichimura, Wataru (Dept. of Therapeutic and Diagnostic Radiology, Obihiro Kohsei Hospital (Japan)); Wakushima, Hiroshi (Dept. of Therapeutic and Diagnostic Radiology, Obihiro Kohsei Hospital (Japan)); Nishioka, Takashi (Dept. of Therapeutic and Diagnostic Radiology, Obihiro Kohsei Hospital (Japan)); Suzuki, Keishiro (Dept. of Therapeutic and Diagnostic Radiology, Obihiro Kohsei Hospital (Japan))

1993-01-01

66

Factores de riesgo para cáncer de cuello uterino Risk factors for uterine cervical cancer  

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Full Text Available El cáncer del cuello uterino es una de las neoplasias malignas de mayor incidencia y mortalidad entre las mujeres de todas partes del mundo, hallazgo que resulta paradójico si se tiene en cuenta que el cuello uterino es de fácil acceso y existen estrategias debidamente probadas que permiten un diagnóstico y tratamiento precoz. En esta revisión se describe detalladamente la epidemiología del cáncer del cuello uterino, en especial los factores de riesgo relacionados con la génesis de la neoplasia y su diagnóstico tardío.Cervical cancer is one of the most frequent neoplasms and one of the most common causes of death among women of reproductive age in the world. These figures are paradoxical if we consider that uterine cervix is easily accessible and that there are proven strategies to early diagnosis and effective treatments. In this paper we provide a detailed review of the epidemiology of cervical cancer, with emphasis on related risk factors associated with carcinogenesis and delayed diagnosis.

Ricardo Ortiz Serrano

2004-06-01

67

Clinicopathological analysis of 91 cases of uterine cervical cancer (including 38 cases of CIN III)  

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A total of 91 cases of uterine cervical cancer, consisting of 38 cases of carcinoma in situ (CIN III) and 53 cases of stage I-IV cervical cancer, were retrospectively and clinicopathologically analyzed. The standard treatment given to these patients consisted of hysterectomy or conization for CIN III; observation of cases of mild to moderate dysplasia; radical hysterectomy plus pelvic lymph node dissection for stage I and II cervical cancer; and radiotherapy for stage III and IV cervical cancer. Postoperative irradiation consisted of irradiation of the whole pelvis with 40-50 Gy. The patients who were not treated surgically underwent 40 Gy external irradiation of the whole pelvis, followed by an additional 20 Gy with shielding and internal irradiation with an RALS. When lymph node metastasis was present, the nodes were irradiated with 40-50 Gy. The mean age of the 38 patients with CIN III was 45.2 years old, and they were para 0-4. In 24 (63.2%) of them the cancer was detected by cytodiagnosis as part of screening. Radical hysterectomy, simple hysterectomy, and conization were performed in 25 patients, 7 patients, and 6 patients, respectively. No recurrences have been detected, and the survival rate is 100%. The mean age of the 53 patients with cervical cancer stage I-IV was 62.4 years old, and they were para 0-10. There were 25 patients with stage I disease, 15 patients with stage II disease, 6 patients with stage III, and 7 patients with stage IV, and their 5-year survival rate was 82.4%, 68.8%, 66.7%, and 42.9%, respectively. Radioenteritis and radiocystitis occurred as adverse radiation effects. Pathologic factors influencing lymph node metastasis were examined by a multivariate analysis based on the data from 25 patients with stage I and II who underwent hysterectomy. The results of the analysis indicated the importance of screening and the choice of appropriate surgical method/technique, as well as the need for further investigation to determine the effective range of dissection to prevent lymph node metastasis. (K.H.)

Obata, Naoko; Kamiya, Norio [Nagoya Memorial Hospital (Japan); Goto, Setsuko; Takahashi, Satoru

2000-07-01

68

External beam boost irradiation for clinically positive pelvic nodes in patients with uterine cervical cancer.  

Science.gov (United States)

The purpose of this study was to retrospectively analyze the treatment results of boost external beam radiotherapy (EBRT) to clinically positive pelvic nodes in patients with uterine cervical cancer. The study population comprised 174 patients with FIGO stages 1B1-4A cervical cancer who were treated with definitive radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT). Patients with positive para-aortic or common iliac nodes (?10 mm in the shortest diameter, as evaluated by CT/MRI) were ineligible for the study. Fifty-seven patients (33%) had clinically positive pelvic nodes. The median maximum diameter of the nodes was 15 mm (range, 10-60 mm) and the median number of positive lymph nodes was two (range, one to four). Fifty-two of 57 patients (91%) with positive nodes were treated with boost EBRT (6-10 Gy in three to five fractions). The median prescribed dose of EBRT for nodes was 56 Gy. The median follow-up time for all patients was 66 months (range, 3-142 months). The 5-year overall survival rate, disease-free survival rate and pelvic control rate for patients with positive and negative nodes were 73% and 92% (P = 0.001), 58% and 84% (P cervical failure and/or distant metastases. No significant difference was observed with respect to the incidence or severity of late complications by application of boost EBRT. The current retrospective study demonstrated that boost EBRT to positive pelvic nodes achieves favorable nodal control without increasing late complications. PMID:23365264

Ariga, Takuro; Toita, Takafumi; Kasuya, Goro; Nagai, Yutaka; Inamine, Morihiko; Kudaka, Wataru; Kakinohana, Yasumasa; Aoki, Youichi; Murayama, Sadayuki

2013-07-01

69

Distribution of Uterin Cervical Lesions and Relation Between Age and Parity Rates in the Mardin Province  

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Full Text Available Objective: The aim of this study is to evaluate the incidence and distribution of cervical lesions and compare characteristics such as parity and age of the women in Mardin province.Material and Method: Pap smears were drawn from the women screened at Mardin Gynecology and Pediatric Diseases Hospital from 2008 to 2011. All cervicovaginal smears were conventional Pap smear samples evaluated according to the 2001 Bethesda system.Results: There were 3.332 patients in total, whose smears showed no lesions in 3.125 patients. The mean age and number of parities of those patients were 37.34±11.25 and 4.78±3.28. There were 207 smears showing any lesions in cervix; ASC-US, ASC-H, LSIL, HSIL, AGC, squamous cell carcinoma and endocervical adenocarcinoma in 151 (72.94%; 16 (7.72%; 20 (9.66%; 8 (3.86%; 10 (4.83%; 1 (0.48% and 1 (0.48% patient, respectively. The mean age and the parities of the patients were 37.63±10.77 years and 4,74±2,92. Although there was no difference between the control and lesion groups, the parity and the age of patients who had ?4 births in both the control and lesion groups were significantly higher than the patients with parities <4 births (p=0.000. There was no difference within the cervical lesion group comparing the ASC-US group with the total of the other lesions.Conclusion: High parity was one of the risk factor for having a lesion in uterine cervix in this population. This study represents an initial attempt to reflect the prevalence and the distribution of cervical lesions and their relation with the parity rates in the eastern regions in Turkey.

Gülay AYDO?DU

2013-01-01

70

High-dose-rate brachytherapy for uterine cervical cancer: the results of different fractionation regimen  

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Although high-dose-rate (HDR) brachytherapy regimens have been practiced with a variety of modalities and various degrees of success, few studies on the subject have been conducted. The purpose of this study was to compare the results of local control and late complication rate according to different HDR brachytherapy fractionation regimens in uterine cervical cancer patients. From November 1992 to March 1998, 224 patients with uterine cervical cancer were treated with external beam irradiation and HDR brachytherapy. In external pelvic radiation therapy, the radiation dose was 45 {approx} 54 Gy (median dose 54 Gy) with daily fraction size 1.8 Gy, five times per week. In HDR brachytherapy, 122 patients (Group A) were treated with three times weekly with 3 Gy to line-A (isodose line of 2 cm radius from source) and 102 patients (Group B) underwent the HDR brachytherapy twice weekly with 4 or 4.5 Gy to line-A after external beam irradiation. Iridium-192 was used as the source of HDR brachytherapy. Late complication was assessed from grade 1 to 5 using the RTOG morbidity grading system. The local control rate (LCR) at 5 years was 80% in group A and 84% in group B ({rho} = 0.4523). In the patients treated with radiation therapy alone, LCR at 5 years was 60.9% in group A and 76.9% in group B ({rho} = 0.2557). In post-operative radiation therapy patients, LCR at 5 years was 92.6% in group A and 91.6% in group B ({rho} 0.8867). The incidence of late complication was 18% (22 patients) and 29.4% (30 patients), of bladder complication was 9.8% (12 patients) and 14.7% (15 patients), and of rectal complication was 9.8% (12 patients) and 21.6% (22 patients), in group A and B, respectively. Lower fraction sized HDR brachytherapy was associated with decrease in late complication ({rho} =0.0405) (rectal complication, {rho} = 0.0147; bladder complication, {rho} =0.115). The same result was observed in postoperative radiation therapy patients ({rho} = 0.0860) and radiation only treated patients ({rho} =0.0370). For radiation only treated patients, a greater number of itemized studies on the proper fraction size of HDR brachytherapy, with consideration for stages and prognostic factors, are required. In postoperative radiation therapy, the fraction size of HDR brachytherapy did not have much effect on local control, yet the incidence of late complication increased with the elevation in fraction size. We suggest that HDR brachytherapy three times weekly with 3 Gy could be an alternative method of therapy.

Yoon, Won Sup; Kim, Tae Hyun; Yang, Dae Sik; Choi, Myung Sun; Kim, Chul Yong [College of Medicine, Korea University, Seoul (Korea, Republic of)

2002-09-15

71

High-dose-rate brachytherapy for uterine cervical cancer: the results of different fractionation regimen  

International Nuclear Information System (INIS)

Although high-dose-rate (HDR) brachytherapy regimens have been practiced with a variety of modalities and various degrees of success, few studies on the subject have been conducted. The purpose of this study was to compare the results of local control and late complication rate according to different HDR brachytherapy fractionation regimens in uterine cervical cancer patients. From November 1992 to March 1998, 224 patients with uterine cervical cancer were treated with external beam irradiation and HDR brachytherapy. In external pelvic radiation therapy, the radiation dose was 45 ? 54 Gy (median dose 54 Gy) with daily fraction size 1.8 Gy, five times per week. In HDR brachytherapy, 122 patients (Group A) were treated with three times weekly with 3 Gy to line-A (isodose line of 2 cm radius from source) and 102 patients (Group B) underwent the HDR brachytherapy twice weekly with 4 or 4.5 Gy to line-A after external beam irradiation. Iridium-192 was used as the source of HDR brachytherapy. Late complication was assessed from grade 1 to 5 using the RTOG morbidity grading system. The local control rate (LCR) at 5 years was 80% in group A and 84% in group B (? = 0.4523). In the patients treated with radiation therapy alone, LCR at 5 years was 60.9% in group A and 76.9% in group B (? = 0.2557). In post-operative radiation therapy patients, LCR at 5 years was 92.6% in group A and 91.6% in group B (? 0.8867). The incidence of late complication was 18% (22 patients) and 29.4% (30 patients), of bladder complication was 9.8% (12 patients) and 14.7% (15 patients), and of rectal complication was 9.8% (12 patients) and 21.6% (22 patients), in group A and B, respectively. Lower fraction sized HDR brachytherapy was associated with decrease in late complication (? =0.0405) (rectal complication, ? = 0.0147; bladder complication, ? =0.115). The same result was observed in postoperative radiation therapy patients (? = 0.0860) and radiation only treated patients (? =0.0370). For radiation only treated patients, a greater number of itemized studies on the proper fraction size of HDR brachytherapy, with consideration for stages and prognostic factors, are required. In postoperative radiation therapy, the fraction size of HDR brachytherapy did not have much effect on local control, yet the incidence of late complication increased with the elevation in fraction size. We suggest that HDR brachytherapy three times weekly with 3 Gy could be an alternative method of therapy

2002-09-01

72

Preoperative [18F]FDG PET/CT maximum standardized uptake value predicts recurrence of uterine cervical cancer  

International Nuclear Information System (INIS)

To determine if preoperative [18F]FDG-PET/CT imaging has prognostic significance in patients with uterine cervical cancer. Patients with FIGO stage IB to IIA cervical cancer were imaged with integrated FDG PET/CT before radical surgery. The relationship between the maximum standardized uptake value (SUVmax) of FDG in the primary tumour during PET/CT and recurrence was examined. Included in the study were 75 patients. Medical records including clinical data, treatment modalities, and treatment results were retrospectively reviewed. The median duration of follow-up was 13 months (range 3 to 58 months) after treatment. Median preoperative SUVmax values in the primary tumours were significantly higher in patients with higher FIGO stages (p = 0.0149), pelvic lymph node metastasis (p = 0.0068), parametrial involvement (p = 0.0002), large (>4 cm) tumour size (p = 0.0022), presence of lymphovascular space invasion (p = 0.0055), and deep cervical stromal invasion (p max (uncategorized values) in the primary tumour were significantly associated with recurrence. However, in multivariate analysis, preoperative SUVmax (p = 0.014, HR 1.178, 95% CI 1.034-1.342), age (p = 0.021, HR 0.87, 95% CI 0.772-0.980), and parametrial involvement (p = 0.040, HR 27.974, 95% CI 1.156-677.043) by primary tumour were significantly associated with recurrence. Preoperative FDG uptake by the primary tumour showed a significant association with recurrence in patients with uterine cervical cancer. (orig.)

2010-08-01

73

Quantification of the configuration factor in class I and II cavities and simulated cervical erosions  

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The configuration factor of adhesive cavities is defined as the ratio of the restoration's bonded to unbonded (free) surfaces. Such a configuration factor was described, on ideal cavities, as having a potential value in predicting the behaviour of the restoration, because it is related to the restoration's capacity for relieving stress by flow. The aim of this study was to measure the configuration factor value for real Class I and II cavities and simulates cervical erosions prepared in molar...

1996-01-01

74

An assessment of interfractional uterine and cervical motion: Implications for radiotherapy target volume definition in gynaecological cancer  

International Nuclear Information System (INIS)

Purpose: To assess interfractional movement of the uterus and cervix in patients with gynaecological cancer to aid selection of the internal margin for radiotherapy target volumes. Methods and materials: Thirty-three patients with gynaecological cancer had an MRI scan performed on two consecutive days. The two sets of T2-weighted axial images were co-registered, and the uterus and cervix outlined on each scan. Points were identified on the anterior uterine body (Point U), posterior cervix (Point C) and upper vagina (Point V). The displacement of each point in the antero-posterior (AP), supero-inferior (SI) and lateral directions between the two scans was measured. The changes in point position and uterine body angle were correlated with bladder volume and rectal diameter. Results: The mean difference (±1SD) in Point U position was 7 mm (±9.0) in the AP direction, 7.1 mm (±6.8) SI and 0.8 mm (±1.3) laterally. Mean Point C displacement was 4.1 mm (±4.4) SI, 2.7 mm (±2.8) AP, 0.3 (±0.8) laterally, and Point V was 2.6 mm (±3.0) AP and 0.3 mm (±1.0) laterally. There was correlation for uterine SI movement in relation to bladder filling, and for cervical and vaginal AP movement in relation to rectal filling. Conclusion: Large movements of the uterus can occur, particularly in the superior-inferior and anterior-posterior directions, but cervical displacement is less marked. Rectal filling may affect cervical position, while bladder filling has more impact on uterine body position, highlighting the need for specific instructions on bladder and rectal filling for treatment. We propose an asymmetrical margin with CTV-PTV expansion of the uterus, cervix and upper vagina of 15 mm AP, 15 mm SI and 7 mm laterally and expansion of the nodal regions and parametria by 7 mm in all directions

2008-08-01

75

Unstable chromosome aberrations on peripheral blood lymphocytes from patients with cervical uterine cancer following radiotherapy  

International Nuclear Information System (INIS)

Absorbed dose determination is an important step for risk assessment related to an exposure to ionizing radiation. However, physical dosimetry cannot be always performed, principally in the case of retrospective estimates. In this context, the use of bioindicators (biological effects) has been proposed, which defines the so-called biological dosimetry. In particular, scoring of unstable chromosomes aberrations (dicentrics, centric rings and fragments) of peripheral blood lymphocytes, while is the most reliable biological method for estimating individual exposure to ionizing radiation. In this work, blood samples from 5 patients, with cervical uterine cancer, were evaluated after partial-body radiotherapy with a source of 69 Co. For this, conventional cytogenetic method was employed, based on Giemsa coloration and fluorescence in situ hybridization, in order to correlate the frequency of unstable chromosome aberrations of blood lymphocytes with absorbed dose, as a result of the radiotherapy. A good agreement was observed between the frequency of chromosome aberrations scored and the values of dose previously calculated by physical dosimetry during patient's radiotherapy. The results presented in this work point out the importance of concerning analyses of unstable chromosome aberrations as biological dosimeter in the investigation of partial-body exposure to ionizing radiation. (author)

2002-01-01

76

Lexington studies of Cf-252 brachytherapy for advanced cervical and uterine cancer  

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The most important tumors selected for study in the Lexington clinical trial of /sup 252/Cf have been the advanced stages of cervical cancer, i.e. stage III and IV. These tumors are poorly controlled by conventional photon radiotherapy and local persistence or pelvic recurrence of tumor occurs commonly after radiotherapy in 60-90% of treated patients. During 1975-1979, a group of patients were treated using conventional radiotherapy with delayed /sup 137/Cs implants, experimental radiation using a delayed /sup 252/Cf implant instead of /sup 137/Cs, and early /sup 252/Cf implants before pelvic irradiation. These schedules and the clinical responses of tumors were studied in sequential studies in the authors' clinic. The characteristics of tumor responses are reviewed as well as patient survival. The early implant schedule was developed to treat tumors when they were of maximal size and presumably radioresistance, presumed due to hypoxia. 5-year survival rates were determined for the different treatments and was 54% for the Cf implants performed early and approximately 15% when delayed /sup 137/Cs or /sup 252/Cf implants were used. These studies indicate that implant schedule was important to outcome for /sup 252/Cf neutron brachytherapy and that the early implant of cervix cancer conferred an advantage for tumor control. Primary and recurrent uterine carcinomas were also studied and were found to be neutron sensitive

1986-01-01

77

Relationship between the cervical uterine cancer evolution and selenium concentration in urine determined by NAA  

International Nuclear Information System (INIS)

Neutron activation analysis of Se in urine reaches an optimum sensitivity (few ppb) and precision (± 12%) when the traces are complexed without using a carrier by ammonium pyrrolidindithiocarbamate (APDC) at pH 1.5-2 and adsorbed on activated carbon filters. In this way the selenium traces analysis have been carried out through 77mSe in 45 urine samples on a pre-separation basis by cyclic activation of the carbon filters. The selenium concentration in our blanks is virtually zero, because APDC proved to be selenium free and selenium mass in 50 mg of activated carbon used as a filter is 20 times below our qualitative detection limit and 144 times below our quantitative detection limit. The samples were first of day urine from healthy and ill women suffering cervical uterine cancer, at different evolution stages: incipient, intermediate and advanced, with no treatment, and surgery, radiotherapy, chemotherapy, or a combined treatment. The results show a consistent trend to increase the selenium trace concentration during the intermediate stage, whereas it is the same than normal for incipient cases, and it decreases to the lowest concentrations for advanced cases. (author)

1996-09-24

78

The Prevalence and pattern of HPV-16 immunostaining in uterine cervical carcinomas in Ethiopian women: a pilot study  

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Full Text Available INTRODUCTION: Cancer of the cervix uteri is the second most common cancer among women worldwide. The association of human papillomavirus (HPV infection with cervical carcinogenesis is well documented. This is a pilot study aiming to studying the prevalence and the pattern of Human Papilloma Virus Type 16 (HPV16 by immunostaining in the tissues of cervical carcinomas of Ethiopian women. METHODS: 20 specimens of uterine cervical carcinomas were studied histopathologically and immunohistochemically for HPV16. RESULTS: Histologically the specimens were classified as: Ten cases were Non Keratinized Squamous cell carcinoma (NKSCC, six cases were Keratinized Squamous Cell Carcinoma (KSCC and four cases were Adenocarcinoma (ADC. Immunohistochemistry study showed positivity in eleven cases (55%; seven cases (35% were non-keratinized squamous cell carcinoma; three cases (15% were keratinized squamous cell carcinoma and one case (5% belonged to the adenocarcinomas. CONCLUSION: This study reveals a significant detection of HPV in Ethiopian women by the use of advanced techniques such as Immunohistochemistry (IHC. The data of this study suggested that the marked expression of the HPV 16 was in the less differentiated uterine cervix carcinomas

Mona M Rashed

2011-03-01

79

Predictive role of post-treatment [18F]FDG PET/CT in patients with uterine cervical cancer  

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Objective: To evaluate the efficacy of post-treatment positron emission tomography (PET)/computed tomography (CT) for identification of tumor recurrence, and to determine whether [18F]fluorodeoxyglucose (FDG) uptake measured as the maximum standardized uptake value (SUVmax) has predictive role regarding survival in patients with uterine cervical cancer. Methods: Medical records from 276 women with uterine cervical cancer who had post-treatment [18F]FDG PET/CT performed were retrospectively reviewed. Results of PET/CT scans were compared with histological or clinical examination. Results: Ninety-five (34.4%) of the 276 patients had documented recurrence by either surgical biopsy or clinical and imaging follow-up. Median duration from treatment to PET/CT scan was 24 months (range, 6–307). The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of post-treatment PET/CT were 94.7%, 87.8%, 80.4%, 97%, and 90.2%, respectively. The PET/CT scan modified both the diagnostic or treatment plan in 67 patients (24.3%). Patients were divided into two groups according to cut-off SUVmax established on the basis of ROC analysis (<5.25 vs. ?5.25), and there was a significant difference in OS between groups (p = 0.001). In addition, the 5-year progression-free survival (PFS) and OS rates of patients with a negative PET/CT scan for recurrence were significantly better than those with a positive PET/CT (98.62% vs. 17.83%, p < 0.0001 for PFS, 99.31% vs. 85.38%, p = 0.0015 for OS). Conclusion: Post-treatment PET/CT scan is a sensitive and accurate surveillance modality, and provides prognostic information in uterine cervical cancer. Furthermore, it may allow individualization of patient care.

2012-08-01

80

Survival prediction using artificial neural networks in patients with uterine cervical cancer treated by radiation therapy alone  

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We evaluated the usefulness of artificial neural networks (ANNs) for survival prediction in patients with uterine cervical cancer treated by radiotherapy. We used data from 134 patients with uterine cervical cancer treated by combined external and high-dose-rate remote afterloading intracavitary radiotherapy between 1978 and 1993. The ANNs were trained using the data from 67 randomly selected patients. Using the trained ANNs, we predicted the 5-year survival in the remaining 67 patients, and compared it with the known 5-year survival. The performance of the ANNs was evaluated using a receiver operating characteristic (ROC) curve and was compared using the area under the ROC curve (Az). When fundamental factors, such as age, performance status, hemoglobin, total protein, International Federation of Gynecology and Obstetrics (FIGO) stage, and histological type were used as inputs in the ANNs, Az was 0.5483{+-}0.0145 (mean{+-}SD). When the histological grading of radiation effect determined by periodic biopsy examination was used in addition to the fundamental factors, Az was highest (0.7782{+-}0.0105). When the cytological grading of radiation effect by the periodic smear was used in addition to the fundamental factors, Az was 0.5523{+-}0.0135, which was not significantly different from that when only the fundamental factors were used. ANNs allow us to evaluate the importance of prognostic factors, and make it possible to predict the survival of each patient. Using ANNs, the combination of histological grading of radiation effect determined by periodic biopsy examination, in addition to the fundamental factors, is the most effective for prediction of survival in patients with uterine cervical cancer. (author)

Ochi, Takashi; Murase, Kenya; Fujii, Takashi; Kawamura, Masashi; Ikezoe, Junpei [Ehime Univ., Shigenobu (Japan). School of Medicine

2002-10-01

 
 
 
 
81

Predictive role of post-treatment [{sup 18}F]FDG PET/CT in patients with uterine cervical cancer  

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Objective: To evaluate the efficacy of post-treatment positron emission tomography (PET)/computed tomography (CT) for identification of tumor recurrence, and to determine whether [{sup 18}F]fluorodeoxyglucose (FDG) uptake measured as the maximum standardized uptake value (SUV{sub max}) has predictive role regarding survival in patients with uterine cervical cancer. Methods: Medical records from 276 women with uterine cervical cancer who had post-treatment [{sup 18}F]FDG PET/CT performed were retrospectively reviewed. Results of PET/CT scans were compared with histological or clinical examination. Results: Ninety-five (34.4%) of the 276 patients had documented recurrence by either surgical biopsy or clinical and imaging follow-up. Median duration from treatment to PET/CT scan was 24 months (range, 6-307). The overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of post-treatment PET/CT were 94.7%, 87.8%, 80.4%, 97%, and 90.2%, respectively. The PET/CT scan modified both the diagnostic or treatment plan in 67 patients (24.3%). Patients were divided into two groups according to cut-off SUV{sub max} established on the basis of ROC analysis (<5.25 vs. {>=}5.25), and there was a significant difference in OS between groups (p = 0.001). In addition, the 5-year progression-free survival (PFS) and OS rates of patients with a negative PET/CT scan for recurrence were significantly better than those with a positive PET/CT (98.62% vs. 17.83%, p < 0.0001 for PFS, 99.31% vs. 85.38%, p = 0.0015 for OS). Conclusion: Post-treatment PET/CT scan is a sensitive and accurate surveillance modality, and provides prognostic information in uterine cervical cancer. Furthermore, it may allow individualization of patient care.

Hoon Chung, Hyun, E-mail: chhkmj@gmail.com [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kim, Jae Weon, E-mail: chhkmj1@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Keon Wook, E-mail: kangkw@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Park, Noh-Hyun, E-mail: pnhkhr@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Song, Yong-Sang, E-mail: yssong@snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Chung, June-Key, E-mail: jkchung@snu.ac.kr [Department of Nuclear Medicine, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of); Kang, Soon-Beom, E-mail: ksboo308@plaza.snu.ac.kr [Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744 (Korea, Republic of)

2012-08-15

82

Radiotherapy for uterine cervical cancer. Results of the 1995-1997 patterns of care process survey in Japan  

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The aim of this study is to establish Japanese national practice patterns for uterine cervical cancer patients who received radiotherapy without surgery. The Japanese Patterns of Care Study (JPCS) conducted a national survey of 73 institutions using two-stage cluster sampling, and collected specific information on 591 patients with uterine cervical cancer treated by radiotherapy without planned surgery between 1995 and 1997. The median age of the patients was 70 years. Karnofsky performance status (KPS) was ?90 for 37%. Most patients (95%) had histology of squamous cell carcinoma. Ten percent were stage I, 29% stage II, 48% stage III and 13% stage IVA. Photon beams of 10-14 MV were the most used for external beam radiotherapy (EBRT). The beam energy utilized varied significantly by institution strata. Midline block was used in ?70% of institutions. Intracavitary brachytherapy (ICBT) was performed in 77%. Institution strata correlated significantly with the ICBT application. The majority of patients (89%) were treated with high-dose-rate (HDR) ICBT. The median single point A dose of HDR-ICBT was 600 cGy. The median summated point A dose from EBRT and HDR-ICBT was 5800 cGy (range: 1196-8600). The median overall treatment time including ICBT was 49 days. Twenty-four percent of the patients received chemotherapy. Concurrent chemoradiation was performed in 5%. The JPCS established the Japanese national practice patterns of care for uterine cervical cancer patients treated with radiotherapy without planned surgery between 1995 and 1997. This survey demonstrated that the institutional strata significantly affected several practice patterns. (author)

2005-03-01

83

Analysis of High Dose Rate Intracavitary Radiotherapy (HDR-ICR) Treatment Planning for Uterine Cervical Cancer  

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Purpose: This study was done to confirm the reference point variation according to variation in applicator configuration in each fractionation of HDR ICR. Materials and Methods: We analyzed the treatment planning of HDRICR for 33 uterine cervical cancer patients treated in department of therapeutic radiology from January 1992 to February 1992. Analysis was done with respect to three view points-Interfractionation A point variation, interfractionation bladder and rectum dose ratio validation, interfractionation treatment volume variation. Interfractionation A point variation was defined as difference between maximum and minimum distance from fixed rectal point to A point in each patient. Interfractionation bladder and rectum dose ration variation was defined as difference between maximum and minimum dose ratio of bladder or rectum to A point dose in each patient.. Interfractionation treatment volume variation was defined as difference between maximum and minimum treatment volume which absorbed over the described dose that is, 350 cGy or 400 cGy-in each patient. Results: The mean of distance from rectum to A point was 4.44cm , and the mean of interfractionation distance variation was 1.14cm in right side, 1.09cm in left side. The mean of bladder and rectum dose ratio was 63.8% and 63.1% and the mean of interfractionation variation was 14.9% and 15.8% respectively. With fixed planning administration of same planning to all fractionations as in first fractionation planning mean of bladder and rectum dose ration was 64.9% and 72.3% and the mean of interfraction variation was 28.1% and 48.1% respectively. The mean of treatment volume was 84.15cm3 and the interfractionation variation was 21.47 cm3. Conclusion: From these data, it was confirmed that there should be adapted planning for every fractionation, and that confirmation device installed in ICR room would reduce the interfractionation variation due to more stable applicator configuration

1994-10-01

84

Evaluation of magnetic resonance imaging in the diagnosis of extension in uterine cervical cancer cases; With special attention to imaging planes  

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To prove the usefulness of magnetic resonance imaging (MRI) in determining the invasion of uterine cervical cancer with imaging planes, we evaluated 44 patients with histologically proved cervical cancer. MRI was performed with a Signa 1.5 T (General Electric), and a T{sub 2}-weighted image was used. In coronal planes, the accuracy was 75.0% for parametrial invasion. It was impossible to diagnose in 77.8%, 92.1% and 63.2% the invasion of the uterine body, bladder, and rectum, respectively. In axial planes, the accuracy was 76.3%, 92.1% and 78.9% for the invasion of parametrium, bladder and rectum, respectively. It was impossible to diagnose in 72.2% the invasion of the uterine body. In sagittal planes, the accuracy was 80.6%, 97.4% and 89.7% for invasion of the uterine body, bladder and rectum, respectively. In all 39 cases it was impossible to diagnose parametrial invasion. In five cases, MRI failed to detect the tumor in any of the three planes, but in three cases it was able to detect the tumor in at least one of the three. We conclude as follows: MRI is a useful method in determining the invasion of cervical cancer. Coronal planes are recommended for the determination of parametrial invasion, axial planes for the parametrium, bladder and rectum, and sagittal planes for the uterine body, bladder and rectum. All three planes are needed to determine cervical cancer. (author).

Goto, Masaki; Okamura, Shinsuke; Ueki, Minoru; Sugimoto, Osamu (Osaka Medical Coll., Takatsuki (Japan))

1990-12-01

85

Uterine Cancer Statistics  

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... Use Social Media Poster Presentation Buttons and Badges Statistics for Other Types of Cancer Breast Cervical Colorectal ( ... Lung Ovarian Prostate Skin Cancer Home Uterine Cancer Statistics Uterine cancer is the fourth most common cancer ...

86

Radiotherapy combined with intracavitary irradiation for uterine cervical cancer. Study of survival rate, patterns of recurrence and complication  

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Survival rates and patterns of recurrence in 137 patients with uterine cervical cancer were determined. These patients were treated by radiotherapy with high-dose rate intracavitary irradiation using remote afterloading system (RALS) at Kyorin University Hospital from Oct. 1987 to Dec. 1992. Age range was from 29 to 87 years. According to clinical staging of UICC, stages I, II, III, and IV were observed in 29, 62, 33, and 13 cases respectively. Cumulative 5-year survival rate of all cases was 72%. Cumulative 5-year survival rates were 100% for stage I, 81% for stage II, 38% for stage III, and 27% for stage IV. Cumulative 5-year survival rates of the postoperative radiotherapy and radical radiotherapy groups were 75% and 90% respectively. There was significant difference of survival rates between the postoperative radiotherapy group and the radical radiotherapy group. As patterns of recurrence, extrapelvic metastasis was more frequent than local recurrence. In stages II and III, recurrent patterns were extrapelvic matastasis in most cases. Of 18 cases with extrapelvic metastasis, there were 10 cases of paraaortic lymph node metastasis. With increase in the control rate of parraortic lymph node metastasis, survival rate of patients with uterine cervical cancer increased. Four of 5 cases with local recurrence controled by intracavitary irradiation is effective for local recurrence control. Rectal and bladder complications following radiotherapy were observed in 25 cases. However, all cases with complication after radiotherapy were treated conservatively, excluding 1 case (vasicorectal fistula). (author)

1994-09-01

87

The relationship between positive peritoneal cytology and the prognosis of patients with FIGO stage I/II uterine cervical cancer  

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Objective The purpose of this study was to assess whether peritoneal cytology has prognostic significance in uterine cervical cancer. Methods Peritoneal cytology was obtained in 228 patients with carcinoma of the uterine cervix (International Federation of Gynecology and Obstetrics [FIGO] stages IB1-IIB) between October 2002 and August 2010. All patients were negative for intraperitoneal disease at the time of their radical hysterectomy. The pathological features and clinical prognosis of cases of positive peritoneal cytology were examined retrospectively. Results Peritoneal cytology was positive in 9 patients (3.9%). Of these patients, 3/139 (2.2%) had squamous cell carcinoma and 6/89 (6.7%) had adenocarcinoma or adenosquamous carcinoma. One of the 3 patients with squamous cell carcinoma who had positive cytology had a recurrence at the vaginal stump 21 months after radical hysterectomy. All of the 6 patients with adenocarcinoma or adenosquamous carcinoma had disease recurrence during the follow-up period: 3 with peritoneal dissemination and 2 with lymph node metastases. There were significant differences in recurrence-free survival and overall survival between the peritoneal cytology-negative and cytology-positive groups (log-rank p<0.001). Multivariate analysis of prognosis in cervical cancer revealed that peritoneal cytology (p=0.029) and histological type (p=0.004) were independent prognostic factors. Conclusion Positive peritoneal cytology may be associated with a poor prognosis in adenocarcinoma or adenosquamous carcinoma of the uterine cervix. Therefore, the results of peritoneal cytology must be considered in postoperative treatment planning.

Hirashima, Yasuyuki; Komeda, Satomi; Tanaka, Aki; Abe, Masakazu; Takahashi, Nobutaka; Takekuma, Munetaka

2014-01-01

88

Primary cervical and uterine corpus lymphoma; a case report and literature review  

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Primary lymphoma of the uterine corpus and cervix is rare. We present a case of primary non-Hodgkin follicular lymphoma isolated to uterine corpus and parametria with focal spread to ovaries and fallopian tubes, incidentally found on the background of endometrial malignancy. A summary of the published cases focusing on the presentation and prognosis as well as a review of current management are discussed. The rising incidence of extra-nodal lymphoma and recent changes in classification and th...

Anagnostopoulos, Antonios; Mouzakiti, Niki; Ruthven, Stuart; Herod, Jonathan; Kotsyfakis, Michail

2013-01-01

89

Neoadjuvant Intra-Arterial Chemotherapy for Locally Advanced Uterine Cervical Cancer: Clinical Efficacy and Factors Influencing Response  

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Purpose: To evaluate the effects of neoadjuvant intra-arterial chemotherapy (NAIC) for locally advanced uterine cervical cancer, and to analyze factors influencing the response to the chemotherapy. Methods: Thirty-four patients with invasive cervical cancer more than 4 cm in diameter were enrolled in this study. NAIC was performed using cisplatin-based regimens. The response was assessed by magnetic resonance imaging (MRI) and examination of surgical specimens. Pretreatment factors involved in the response to NAIC were evaluated and the relationship between the factors and the prognosis was assessed. Results:Clinical response was achieved in 28 (82%) patients. Thirty-one of 49 invasions in the parametrial halves disappeared. Seventeen of 28 lymphnode swellings responded to NAIC. Six of the 14 stage III patients became operable. In the 19 surgical cases, pathologically complete responses were found in four. Twenty-eight of the 38 parametrial halves were free from cancer. No lymph node metastases were found in eight patients. Initial tumor volume was found to be an independent, significant determining factor of the response to NAIC. Patients with initial tumor volumes less than 80 cm3 had a significantly better estimated 5-year disease-free survival rate compared with those with larger tumors. Conclusion: NAIC for locally advanced cervical cancer is useful for preoperative tumor reduction.Tumor volume is a significant determining factor for the response to NAIC

2003-06-01

90

A Case of Cervical Pregnancy Following Uterine Curettage: The Most Advanced in Iranian Population  

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Full Text Available A case of cervical ectopic pregnancy in a 37 years old woman with history of two previous cesarean sections and one dilatation/curettage. The case was the advanced cervical pregnancy reported in Iran, which diagnosed in 12 week of gestation by MRI and finally treated by hysterectomy.

Zahra Najmi

2011-09-01

91

A Case of Cervical Pregnancy Following Uterine Curettage: The Most Advanced in Iranian Population  

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A case of cervical ectopic pregnancy in a 37 years old woman with history of two previous cesarean sections and one dilatation/curettage. The case was the advanced cervical pregnancy reported in Iran, which diagnosed in 12 week of gestation by MRI and finally treated by hysterectomy.

Monir Ashouri; Ashraf-Sadat Mousavi; Zahra Najmi; Mahjabin Marashi

2011-01-01

92

High dose-rate brachytherapy for elderly patients with uterine cervical cancer  

International Nuclear Information System (INIS)

The need for radiotherapy (RT) in cancer treatment for the elderly patient is growing. The purpose of this study was to analyze the efficacy and complication rate for radiotherapy, using external-beam irradiation (EBRT) and high dose-rate intracavitary brachytherapy (HDRICB), for patients aged 70 years or older with carcinoma of the uterine cervix. From September 1992 to December 1997, 295 patients diagnosed with uterine cervical cancer completed RT at the Shin Kong Memorial Hospital and China Medical College Hospital. Two hundred and fifty-eight patients [International Federation of Gynecology and Obstetrics (FIGO) stage distribution: 35 Ib, 26 IIa, 122 IIb, 10 IIIa, 58 IIIb, 7 IVa] who had undergone at least two courses of HDRICB and a minimum of 3 years of follow-up, were evaluated. A retrospective analysis was conducted to compare the outcome of radiation therapy for the 179 patients under 70 years of age (younger group) and the 79 patients aged 70 years or older (older group). The RT consisted of EBRT followed by HDRICB. After a total EBRT dose of 40-45 Gy/20 in 25 fractions, irradiating the whole pelvis over 4-5 weeks, dosage for patients diagnosed as FIGO stage IIb-IVa bilateral parametrial disease was boosted to 54-58 Gy, with central shielding. HDRICB was administered at 1-week intervals using an Ir-192 remote after-loading technique. Ninety-nine patients (38.4%) received three fractions of HDRICB, while 156 patients (60.5%) had four fractions. Total prescribed Point A dosages (EBRT+HDRICB) ranged from 58 to 71.6 Gy (median, 65.6 Gy) for stage IB-IIA, while for larger lesions (stage IIB-IVA) analogous dosages were 59-75.6 Gy (median, 65.6 Gy). Median follow-up durations for the older and younger groups were 56/55 months, respectively. The respective 5-year actuarial survivals (AS) for the older and younger groups were 82/85% for stage Ib, 65/65% for IIa, 61/71% for IIb and 35/59% for IIIa-b. The 5-year cause-specific survivals (CSS) for the older and younger groups were 100/95% for stage Ib, 85/75% for IIa, 78/72% for IIb and 42/61% for IIIa-b. The 5-year pelvic relapse-free survivals (PRFS) for the older and younger groups were 100/100% for stage Ib, 91/93% for IIa, 91/90% for IIb and 67/80% for IIIa-b. The 5-year distant metastasis-free survivals (DMFS) for older and younger groups were 100/100% for stage Ib, 92/88% for IIa, 84/73% for IIb and 55/75% for IIIa-b. There was no statistically significant survival difference on comparing the two groups according to stage. The gross tumor-free ratios after EBRT (NRT) for the older and younger groups were 44.3/24.5% (P=0.001). The 5-year CSS for the 35 NRT patients was 88% for the older group, while for the 44 patients diagnosed with gross residual tumor after EBRT (GRT) it was 64% (P=0.001). Twelve (15.0%) of the 79 older patients and 14 (7.8%) of the 179 younger patients developed Radiation Therapy Oncology Group (RTOG) grade 3-4 rectal complications (P=0.12), while seven (8.9%) of the 79 older patients and 10 (5.6%) of the 179 younger patients developed RTOG grade 3-4 small bowel complications (P=0.34). Radiation therapy, consisting of a combination of EBRT and three or four fractions of HDRICB, proved to be effective for older patients. Further optimization of treatment policy is essential by changing the HDRICB fractionation strategy, shortening the treatment time and designing combination drug regimens that are both effective and tolerable during radiotherapy. (author)

2003-05-01

93

Cerebellar metastases in patients with uterine cervical cancer. Two cases reports and review of the literature; Metastases cerebelleuses chez des patientes atteintes d'un cancer du col uterin. A propos de deux cas et revue de la litterature  

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Brain metastases from cervical cancer are extremely rare. We report on two patients who developed cerebellar metastases following uterine cervical cancer. The interval between diagnosis of the primary cancer and diagnosis of brain metastasis was 8 months. The main complaint was symptoms of increased intracranial pressure and cerebellar syndrome. Surgical excision of the brain lesion followed by radiation therapy was performed in the first case. The second patient received palliative radiation therapy. The first patient died 8 months after diagnosis. The second patient is alive 2 months after diagnosis. (authors)

El Omari-Alaoui, H.; Gaye, P.M.; Kebdani, T.; El Ghazi, E.; Benjaafar, N.; Mansouri, A.; Errihani, H.; Kettani, F.; El Ouahabi, A.; El Gueddari, B.K. [Institut National d' Oncologie, Service de Radiotherapie, Rabat (Morocco)

2003-10-01

94

The prediction of late rectal complications following the treatment of uterine cervical cancer by high-dose-rate brachytherapy  

International Nuclear Information System (INIS)

Purpose: This study aimed to correlate patient, treatment, and dosimetric factors with the risk of late rectal sequelae in patients with uterine cervical cancer treated with external beam radiation therapy (EBRT) and high dose rate intracavitary brachytherapy (HDRICB). Methods and Materials: From September 1992 to December 1995, a total of 128 patients with uterine cervical cancer, who were treated and survived more than 12 months, were evaluated. After EBRT with 40-44 Gy/20-22 Fr/4-5 weeks to the whole pelvis, the dose was boosted up to 54-58 Gy with central shielding for patients with bilateral parametria of Stage IIb or greater. HDRICB consisted of three to four insertions at doses of 5-7.2 Gy (to Point A) at intervals of 1 week. Patient and treatment factors were analyzed using logistic regression analysis and the cumulative rectal biologic equivalent dose (CRBED) was calculated. Results: After 30-75 months of follow-up (median, 43 months), 38 patients (29.7%) had late rectal sequelae. Patients who had Stage IIb-IVa disease, cumulative rectal dose (external RT + total ICRU rectal dose) greater than 65 Gy, or age greater than 70 years had a high risk of developing late rectal sequelae. When 110 Gy was used as the cut-off value, 19.6% (10 of 51) of patients whose CRBED was less than 110 Gy had rectal complications, while 36.4% (28/77) of patients whose CRBED was greater than 110 Gy developed rectal complications. Conclusion: Risk factors of late rectal complications were advanced stage, age greater than 70 years, and cumulative rectal dose of greater than 65 Gy

2000-07-01

95

The effects of PS-K on long-term survival of uterine cervical cancer patients treated with radiation  

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The effects of PS-K on long-term survival of uterine cervical cancer patients treated with radiation was studied. The patients receiving PS-K were anxious about curability more or less at the time of completion of radiation therapy. Between 1977 and 1983, out of 96 patients with stage III, IV uterine cervical cancer treated with radiation, 27 were given PS-K as adjuvant therapy. The number of cases with PS-K administration were 15 (23 %) out of 64 in stage IIIb, seven (37 %) out of 19 in stage IVa and five (38 %) out of 13 in stage IVb. Out of 27 patients administered PS-K, 19 were given the agent within three months after irradiation and the remaining eight after recognition of recurrence or metastasis. As a rule, PS-K was given orally, 3.0 g per day, intermittently in the pattern of two weeks per month. Judgement of the effects of PS-K was made in comparison with the survival rate of the patients with and without PS-K, and then by observation of the changes of the PPD skin test, ESR, appetite and body weight as early effectiveness of PS-K. The results were as follows. 1) Obvious prolongation of survival was recognized in the patients with PS-K after irradiation. Namely, the cumulative five-year survival rates of stage IIIb were 65 % and 49 % with and without PS-K, respectively. 2) Improvement by PS-K as early effectiveness was obtained in seven cases (37 %) out of 19. 3) The conditions necessary for long-term survival with PS-K were thought to be follows: that the tumor almost disappears as a result of irradiation and that the condition of the host is superior to that of the tumor in the tumor-host relationship. 4) The effectiveness of intermittent administration of PS-K was suggested. (author)

1986-01-01

96

Conditionally replicating E1B-deleted adenovirus driven by the squamous cell carcinoma antigen 2 promoter for uterine cervical cancer therapy.  

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Cervical cancer is the second most common type of malignant tumor among women worldwide. When the disease is confined locally, it can be controlled with surgical resection and radiotherapy. However, patients with recurrent or metastatic disease often have a poor prognosis. Measurement of serum levels of squamous cell carcinoma (SCC) antigens has been widely used as serological markers for SCC of uterine cervix. Recently, it has been demonstrated that cervical cancer patients with elevated squamous cell carcinoma antigen-2 (SCCA2) expression in tumor cells carry a poor prognosis. Here, by using a luciferase reporter assay, we show that SCCA2 promoter was active in SCCA2-producing human cervical cancer cell lines, including Cx, Cxwj, SiHa and HeLa cells, but relatively quiescent in normal cervical epithelial cells. We then developed a conditionally replicating adenovirus, designated Ad-KFH, under the transcriptional control of the SCCA2 promoter. This E1B-55 kDa-deleted oncolytic adenovirus replicated specifically in and lysed SCCA2-producing cervical cancer cells. Furthermore, in a peritoneal metastatic tumor model, Ad-KFH retarded Cxwj tumor growth in NOD/severe combined immunodeficient mice and prolonged survival of tumor-bearing mice, especially when combined with cisplatin. These results suggest that Ad-KFH may provide a new strategy of gene therapy for advanced or recurrent uterine cervical cancer. PMID:18497852

Hsu, K-F; Wu, C-L; Huang, S-C; Hsieh, J-L; Huang, Y-S; Chen, Y-F; Shen, M-R; Chung, W-J; Chou, C-Y; Shiau, A-L

2008-08-01

97

Expression of Bmi-1, P16, and CD44v6 in Uterine Cervical Carcinoma and Its Clinical Significance  

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Full Text Available Objective: Bmi-1, a putative proto-oncogene, is a core member of the polycomb gene family, which is expressed in many human tumors. The p16 protein negatively regulated cell proliferation, whereas CD44v6 is associated with proliferation as an important protein. Additionally, CD44v6 is an important nuclear antigen closely correlated to tumor metastasis. The present study aims to investigate the expression and significance of Bmi-1, p16, and CD44v6 in uterine cervical carcinoma (UCC. Methods: A total of 62 UCC, 30 cervical neoplasic, and 20 normal cervical mucosal tissues were used in the current study. The expression of Bmi-1, p16, and CD44v6 in these tissues was determined using immunohistochemical assay. The relationships among the expression of these indices, the clinicopathologic features of UCC, and the survival rate of UCC patients were also discussed. The correlation between Bmi-1 protein expression and p16 or CD44v6 protein in UCC was analyzed. Results: The expression of Bmi-1, p16, and CD44v6 was significantly high in cervical carcinoma compared with that in the cervical neoplasia and normal colorectal mucosa (P0.05. The Kaplan–Meier survival analysis showed that the over-expression of Bmi-1 significantly decreased the survival rate of UCC patients (P<0.05. A strong correlation indicated that there was statistical significance between the expression of Bmi-1 and CD44V6 proteins in UCC (r=0.419, P=0.001. Conclusions: The over-expression of Bmi-1 and CD44v6 protein closely correlate to the tumorigenesis, metastasis, and prognosis of UCC. Bmi-1 and CD44v6 may be used to predict the prognosis of cervical carcinoma. Bmi-1 may indirectly regulate the expression of CD44v6 in UCC patients. The positive expression of p16 protein is possibly associated with the tumorigenesis, but not with the metastasis or prognosis of UCC.

Mei-ying Weng

2012-03-01

98

Comparison of DNA hypermethylation patterns in different types of uterine cancer: cervical squamous cell carcinoma, cervical adenocarcinoma and endometrial adenocarcinoma.  

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The incidence of cervical adenocarcinoma (CA) is rising, whereas the incidence of cervical squamous cell carcinoma (CSCC) continues to decrease. However, it is still unclear whether different molecular characteristics underlie these 2 types of cervical carcinoma. To better understand the epigenetic characteristics of cervical carcinoma, we investigated the DNA promoter hypermethylation profiles in CA and CSCC. In addition, we investigated whether DNA hypermethylation patterns might be used for the molecular diagnosis of CA and endometrial adenocarcinoma (EA). Using the bisulfite-modification technique and methylation-specific PCR, we examined the aberrant promoter hypermethylation patterns of 9 tumor suppressor genes (APC, DAPK, CDH1, HLTF, hMLH1, p16, RASSF1A, THBS1 and TIMP3) in 62 CSCCs, 30 CAs and 21 EAs. After Bonferroni correction adjustment (statistically significant at p HLTF and TIMP3 were more frequently methylated in CAs (3.2% vs. 43.3%, p < 0.001; 8.1% vs. 53.3%, p = 0.001). The hypermethylations of RASSF1A and APC were more frequent in CAs than in CSCCs, but this was not significant (9.7% vs. 33.3%, p = 0.008; and 14.5% vs. 40.0%, respectively, p = 0.009). In addition, RASSF1A hypermethylation was significantly more frequent in EAs than in CAs (81.0% vs. 33.3%, p = 0.001). In conclusion, the existence of these unique methylation patterns in these cancers suggests that their tumorigenesis may involve different epigenetic mechanisms. PMID:16331610

Kang, Sokbom; Kim, Jae Weon; Kang, Gyeong Hoon; Lee, Sun; Park, Noh Hyun; Song, Yong Sang; Park, Sang Yoon; Kang, Soon Beom; Lee, Hyo Pyo

2006-05-01

99

Adjuvant chemotherapy following concurrent chemoradiotherapy for uterine cervical cancer with lymphadenopathy  

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The present study aimed to retrospectively evaluate the efficacy and toxicities of adjuvant chemotherapy with paclitaxel and carboplatin (TC) following concurrent cisplatin-based chemoradiation (CCRT) in patients with cervical cancer with lymphadenopathy (N1). A total of 37 patients with FIGO stage IB2-IVA cervical carcinoma with N1 (median age 57 years, range 31–74 years) were enrolled. External beam radiation therapy was followed by high-dose-rate brachytherapy. In cases of suspected para...

Abe, Akiko; Furumoto, Hiroyuki; Nishimura, Masato; Irahara, Minoru; Ikushima, Hitoshi

2012-01-01

100

Glandular cells derived from direct sampling of the lower uterine segment in patients status post-cervical cone biopsy. A diagnostic dilemma.  

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Direct sampling of the lower uterine segment endometrium (LUS) may mimic atypical glandular lesions or resemble the cells of high grade squamous intraepithelial lesion. This study was done to further characterize the cytologic features of LUS and to determine the incidence of these cells in patients who have previously undergone cone biopsies. Cervical smears from 64 patients who had had a previous cervical cone biopsy were reviewed and compared to pre-cone cervical smears and any post-cone cervical biopsies or endocervical curettage specimens. Twelve smears from 63 patients (19%) were found to have fragments of LUS. Cytologic features of LUS included large groups with gland openings, branched glands, and nuclear palisading within the fragments. The fragments often were accompanied by endometrial stroma. Smaller fragments were frequently encountered. These were densely cellular but contained nuclear palisading. PMID:8853041

Heaton, R B; Harris, T F; Larson, D M; Henry, M R

1996-10-01

 
 
 
 
101

Results of radiation alone versus neoadjuvant chemotherapy and radiation in locally advanced stage of uterine cervical cancer  

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This is retrospective study to compare the results of radiation therapy alone and neoadjuvant chemotherapy and radiation in advanced stage of uterine cervical cancer. Seventy-six patients who were treated with definitive radiation therapy for locally advanced cervical carcinoma 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 IIIb 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. 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-year 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 year 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 80.3% in radiation alone group and 89.9% in chemoradiation group (P=0.42). Bone marrow suppression was noted in 3 cases of radiation 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 performance treated with surgery (1 patient) were noted in radiation alone group. There was no statistical difference in complication between two groups. There was no statistical difference in survival, failure and complication between neoadjuvant chemotherapy and radiation versus radiation alone in locally advanced uterine cervical carcinoma. (author)

1997-09-01

102

Local lymphocytes and nitric oxide synthase in the uterine cervical stroma of patients with grade III cervical intraepithelial neoplasia  

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Full Text Available OBJECTIVES: Precancerous and cancerous cells can trigger an immune response that may limit tumor development and can be used as a prognostic marker. The aims of the present study were to quantify the presence of B and T lymphocytes, macrophages and cells expressing inducible nitric oxide synthase (iNOS in the cervical stroma of women with grade III cervical intraepithelial neoplasia (CIN III or in the intratumoral and peritumoral tissue of women with stage I invasive carcinoma. METHODS: Cervical tissue specimens were obtained from 60 women (20 each from control tissues, CIN III and invasive carcinomas. The average ages in the control, CIN III and invasive groups were 43.9 (± 4.3, 35.5 (± 9.5, and 50 (± 11.2 years, respectively. The specimens were immunohistochemically labeled with antibodies to identify T lymphocytes (CD3, cytotoxic lymphocytes (CD8, B lymphocytes (CD20, macrophages (CD68 and iNOS. We evaluated the markers in the stroma above the squamocolumnar junction (control, at the intraepithelial lesion (CIN cases, and in the nfiltrating tumor. Two independent observers performed the immunohistochemical analysis. RESULTS: T lymphocytes, B lymphocytes, macrophages and iNOS were present more frequently (P<0.05 in the stroma of peritumoral invasive tumors compared to the controls and intratumoral invasive cancer samples. CD3+ and CD20+ lymphocytes were present more frequently in CIN III patients compared to samples from patients with intratumoral invasive cancer (P<0.05. CONCLUSION: High numbers of T and B lymphocytes, macrophages and iNOS-expressing cells in the peritumoral stroma of the invasive tumors were observed. Cell migration appeared to be proportional to the progression of the lesion.

Cléber Sergio da Silva

2010-01-01

103

HPV type 18 is more oncopotent than HPV16 in uterine cervical carcinogenesis although HPV16 is the prevalent type in Chennai, India  

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Context: The highest incidence of uterine cervical cancer in India is reported in Chennai. The prevalence and oncopotency are to be considered for the development of vaccines and therapeutic agents. Aims: The aim of the present study is to analyze the prevalence and oncopotency of high risk type HPV16 and 18 in cervical lesions. Settings and Design: This study is designed with 130 study subjects for analysis of selected types of HPV 6/11 and 16/18, in four groups, in...

Berlin Grace V

2009-01-01

104

Colposcopic, cytologic and isotopic methods in early diagnosis of uterine cervical carcinoma  

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The authors examined 112 women with changes in the uterine cervix using colposcopic, cytologic and isotopic methods. Comparing the obtained data of each method on the one side, and taking histological results as a basis for comparison of the exactness, on the other hand, they come to the following conclusions: (1) Carcinoma in development is diagnosed by means of colposcopy more surely in comparison with the remaining methods. (2) For establishing the earliest form of cancerous disease of the uterine cervix the cytological method gives positive data than the remaining two methods. (3) The isotopic method, based on the level of phosphorus 32 accumulation, gives less exact information in comparison with the colposcopic and cytologic methods. (4) The complex application of the three methods gives a possibility for correction of the mistakes of each method, used singly. (author)

1977-01-01

105

Metastatic cervical lymphadenopathy from uterine leiomyosarcoma with good local response to radiotherapy and chemotherapy  

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The metastasis of uterine leiomyosarcoma to the neck node has not been reported previously and the radiotherapy has been rarely used for the metastatic lesion of the other sites. We report a case of neck metastasis from a uterine leiomyosarcoma, which developed 10 months after surgery and postoperative pelvic radiotherapy. It also involved the parapharyngeal space, adjacent spine, and spinal canal. The metastatic neck mass was inoperable, and was treated by neck radiotherapy (6,000 cGy) and chemotherapy including taxol and carboplatin. The mass has regressed progressively to a nearly impalpable state. She has never developed spinal cord compression syndrome, and has maintained good swallowing for eight months since the neck radiotherapy and chemotherapy. Since the extensive metastatic neck mass showed good local response to high dose radiotherapy and chemotherapy, both treatments may be considered for an unresectable metastatic leiomyosarcoma

2000-12-01

106

Metastatic cervical lymphadenopathy from uterine leiomyosarcoma with good local response to radiotherapy and chemotherapy  

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The metastasis of uterine leiomyosarcoma to the neck node has not been reported previously and the radiotherapy has been rarely used for the metastatic lesion of the other sites. We report a case of neck metastasis from a uterine leiomyosarcoma, which developed 10 months after surgery and postoperative pelvic radiotherapy. It also involved the parapharyngeal space, adjacent spine, and spinal canal. The metastatic neck mass was inoperable, and was treated by neck radiotherapy (6,000 cGy) and chemotherapy including taxol and carboplatin. The mass has regressed progressively to a nearly impalpable state. She has never developed spinal cord compression syndrome, and has maintained good swallowing for eight months since the neck radiotherapy and chemotherapy. Since the extensive metastatic neck mass showed good local response to high dose radiotherapy and chemotherapy, both treatments may be considered for an unresectable metastatic leiomyosarcoma.

Oh, Yoon Kyeong; Park, Hee Chul; Kee, Keun Hong; Jeon, Ho Jong; Park, You Hwan; Chung, Choon Hai [College of Medicine, Chosun Univ., Kwangju (Korea, Republic of)

2000-12-01

107

Antitumor Effects of Camptothecin Combined with Conventional Anticancer Drugs on the Cervical and Uterine Squamous Cell Carcinoma Cell Line SiHa  

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Functional defects in mitochondria are involved in the induction of cell death in cancer cells. We assessed the toxic effect of camptothecin against the human cervical and uterine tumor cell line SiHa with respect to the mitochondria-mediated cell death process, and examined the combined effect of camptothecin and anticancer drugs. Camptothecin caused apoptosis in SiHa cells by inducing mitochondrial membrane permeability changes that lead to the loss of mitochondrial membrane potential, decr...

2009-01-01

108

Prognostic value of c-erbB-2 expression in uterine cervical carcinoma.  

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AIMS: To study the pattern of expression and prognostic importance of c-erbB-2 protein in cervical carcinoma. METHODS: Sixty two cases of stage IB/IIA cervical carcinoma, representing the three main tumour types, were investigated immunohistochemically for the presence of c-erbB-2 protein expression, using a monoclonal antibody (CB11) to its internal domain. Follow up of at least five years' duration was available in all cases. RESULTS: Definite membrane staining was seen in 38.7% of cases. T...

Hale, R. J.; Buckley, C. H.; Fox, H.; Williams, J.

1992-01-01

109

Genomic amplification of the human telomerase gene (hTERC associated with human papillomavirus is related to the progression of uterine cervical dysplasia to invasive cancer  

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Full Text Available Abstract Background Human papillomavirus (HPV infection plays an etiological role in the development of cervical dysplasia and cancer. Amplification of human telomerase gene (hTERC and over expression of telomerase were found to be associated with cervical tumorigenesis. This study was performed to analyze genomic amplification of hTERC gene, telomerase activity in association with HPV infection in different stages of cervical intraepithelial neoplasia (CIN and cervical cancer. We were studying the role of hTERC in the progression of uterine cervical dysplasia to invasive cancer, and proposed an adjunct method for cervical cancer screening. Methods Exfoliated cervical cells were collected from 114 patients with non neoplastic lesion (NNL, n=27, cervical intraepithelial neoplasia (CIN1, n=26, CIN2, n=16, CIN3, n=24 and cervical carcinoma (CA, n=21, and analyzed for amplification of hTERC with two-color fluorescence in situ hybridization (FISH probe and HPV-DNA with Hybrid Capture 2. From these patients, 53 were taken biopsy to analyze telomerase activity by telomeric repeat amplification protocol (TRAP and expression of human telomerase reverse transcriptase (hTERT, with immunohistochemistry (IHC. All biopsies were clinically confirmed by phathologists. Results Amplification of hTERC was significantly associated with the histologic diagnoses (p Conclusions hTERC ampliffication can be detected with FISH technique on exfoliated cervical cells. Amplification of hTERC and HPV infection are associated with more progressive CIN3 and CA. The testing of hTERC amplification might be a supplementary to cytology screening and HPV test, especially high-risk patients. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1857134686755648.

Liu Hongqian

2012-10-01

110

Apparent rarity of asymptomatic herpes cervicitis in a woman with intra-uterine contraceptive device  

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Full Text Available Infection with genital herpes simplex virus (HSV remains a common viral sexually transmitted disease, often subclinical and a major worldwide problem of women of reproductive age group. Herpes cervicitis is an unusual presentation of Herpes simplex virus infection in females. The finding of herpes cervicitis on routine pap smear of an asymptomatic woman on Intrauterine contraceptive device still further supports the need for increased awareness on the possibility of Herpes simplex virus infection among women, particularly those on Intrauterine contraceptive device. The index case is a 28 years old Nigerian female who was referred to our Special Treatment Clinic on account of an abnormal pap smear cytology which was in keeping with Herpes cervicitis. There was no history of genital ulcer in this patient; however ELISA for HSV 2 IgM was positive in her. We therefore describe a case of herpes cervicitis in an asymptomatic woman on intrauterine contraceptive device. This case highlights to clinicians the need to be aware of the possibility of this association and to carry out relevant investigations so as to identify and treat these patients appropriately. Therefore, there is a need to put in place adequate public health intervention strategy to prevent genital herpes in women of reproductive age group with a view to preventing the possibility of congenital herpes in subsequent pregnancy.

Adeola Fowotade

2013-12-01

111

El cáncer cervicouterino y las lesiones precursoras: revisión bibliográfica / Cervical-uterine cancer and precursor lesions: a literature review  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Con el objetivo de actualizar el estado del arte sobre el cáncer cervicouterino y las lesiones precursoras se realizó una revisión bibliográfica de los artículos publicados en los últimos 5 años, y de otros originales teniendo en cuenta su nivel de evidencia médica I - II. Se utilizaron los buscador [...] es de la biblioteca Cochrane, Dynamed, Evidence-Based Medicine Updates, New England Journal of Medicine, J Clinical Oncology, Medscape, PubMed, PubMed Central y artículos de la Agencia Internacional del Cáncer de Francia. Se revisaron los siguientes aspectos: Definiciones, epidemiología, etiología, factores de riesgo, citología, colposcopia, histopatología, clasificaciones, estadios clínicos, tratamientos, prevención, promoción de salud y problemas sociales. El cáncer cervicouterino es una enfermedad prevenible y curable, multifactorial, trasmitida sexualmente por el Virus del Papiloma Humano, con alta incidencia y prevalencia, y a pesar de los programas de pesquisaje continúa siendo un problema de salud. Se necesita de monitoreo permanente del programa de detección precoz en todos los ámbitos y alternativas de pesquisaje, adecuadas localmente a las necesidades, y de fuertes prevención y tratamiento para poder disminuir la carga social y económica que de este problema se derivan. Abstract in english Aimed at knowing the state of the art of cervical-uterine cancer and precursor lesions a literature review was carried out supported on the articles published in the last five years and from other original sources considering the levels I-II of medical evidences. Health information sources from Coch [...] rane, Dynamed, Evidence-Based Medicine Updates, New England Journal of Medicine, Journal of Clinical Oncology, Medscape, PubMed, Central PubMed and French International Cancer Agency were used to revise the following aspects: definitions, epidemiology, etiology, risk factors, cytology, colposcopy, histopathology, classifications, clinical stages, treatments, prevention, health promotion and social problems. Cervical-uterine is a preventable, curable and multifactorial disease that is sexually transmitted by Human Papilloma Virus, presenting a high incidence and prevalence. Despite continuing screening programs, it is a health problem. Permanent monitoring programs to the early detection of this entity from all scopes must be carried out, along with screening alternatives that should be adjusted to the local needs, as well as the design of prevention and treatment programs to reduce social and economic burden resulting from this health problem.

Sanabria Negrín, José Guillermo; Fernández Montequín, Zoila C; Cruz Hernández, Inalvis de la Caridad; Pérez, Leonardo Oriolo; Llanuch Lara, Margarita.

112

Optimum Dose Combination of External Radiation and High Dose Rate ICR in FIGO IB Uterine Cervical Cancer  

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Purpose : To assess the efficacy of high dose rate - intracavitary radiotherapy (HDR-ICR) in the radiotherapy of FIGO stage IB squamous cell carcinoma of uterine cervix and to determine the optimum dose combination xheme of external radiotherapy and ICR to achieve acceptable local control without severe complication. Methods and Materials : One hundred and sixty two patients with FIGO stage Ib squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external radiotherapy combined with HDR-ICR. External dose of 40-46 Gy in 4.5-5 weeks was given to whole pelvis(median 45 Gy) and ICR dose of 30-39 Gy in 10-13 times was given to the point A. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy). Summation of external dose plus ICR dose to the point A range were 64.20-95.00 Gy, and mean was 83.94 Gy. We analyzed the local control rate, survival rate, and late complication rate. Results : Initial complete response rate was 99.4% for all patients. Overall 5-year survival rate was 91.1% and 5-year disease free survival rate was 90.9%. Local failure rate was 4.9% and distant failure rate was 4.3% Tumor size was the only significant prognostic factor. When tumor size greater than 3cm, 5-year survival rate was 92.6% and less than 3cm, that was 79.6%, Late complication rate was 23.5% with 18.5% of rectal complication and 4.9% of bladder complication. Mean rectal dose summation of external midline dose plus ICR rectal point dose was lower in the patients without rectal complication(74.88 Gy) than those with rectal complication (78.87 Gy). Complication rate was increased with low rate of improvement of survival rate when summation of external midline dose plus point A or point R dose by ICR was greater than 70-75 Gy. Conclusion : The definitive radiation therapy using high dose rate ICR in FIGO stage IB uterine cervical cancer is effective treatment modality with good local control and survival rate without severe complication.

Lee, Sang Wook; Suh, Chang Ok; Chung, Eun Ji; Kim, Woo Cheol; Chang, Sei Kyung; Keum, Ki Chang; Kim, Gwi Eon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

1996-09-15

113

Optimum Dose Combination of External Radiation and High Dose Rate ICR in FIGO IB Uterine Cervical Cancer  

International Nuclear Information System (INIS)

Purpose : To assess the efficacy of high dose rate - intracavitary radiotherapy (HDR-ICR) in the radiotherapy of FIGO stage IB squamous cell carcinoma of uterine cervix and to determine the optimum dose combination xheme of external radiotherapy and ICR to achieve acceptable local control without severe complication. Methods and Materials : One hundred and sixty two patients with FIGO stage Ib squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external radiotherapy combined with HDR-ICR. External dose of 40-46 Gy in 4.5-5 weeks was given to whole pelvis(median 45 Gy) and ICR dose of 30-39 Gy in 10-13 times was given to the point A. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy). Summation of external dose plus ICR dose to the point A range were 64.20-95.00 Gy, and mean was 83.94 Gy. We analyzed the local control rate, survival rate, and late complication rate. Results : Initial complete response rate was 99.4% for all patients. Overall 5-year survival rate was 91.1% and 5-year disease free survival rate was 90.9%. Local failure rate was 4.9% and distant failure rate was 4.3% Tumor size was the only significant prognostic factor. When tumor size greater than 3cm, 5-year survival rate was 92.6% and less than 3cm, that was 79.6%, Late complication rate was 23.5% with 18.5% of rectal complication and 4.9% of bladder complication. Mean rectal dose summation of external midline dose plus ICR rectal point dose was lower in the patients without rectal complication(74.88 Gy) than those with rectal complication (78.87 Gy). Complication rate was increased with low rate of improvement of survival rate when summation of external midline dose plus point A or point R dose by ICR was greater than 70-75 Gy. Conclusion : The definitive radiation therapy using high dose rate ICR in FIGO stage IB uterine cervical cancer is effective treatment modality with good local control and survival rate without severe complication

1996-09-01

114

Three cases of colorectal cancer after radiotherapy for the uterine cervical cancer  

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Three cases of colorectal cancer that developed after radiotherapy for cervical cancer are reported. In all cases. the pathology of the initial cancers was squamous cell carcinoma, while that of the second cancer was adenocarcinoma. The latency period was more than 5 years in each case. There was no significant difference between observed number and expected number in the incidences of colorectal cancer. Long-term follow-up procedures are necessary because radiation may contribute to the induction of colorectal cancer. (author)

Torii, Kenji; Tsumura, Masashi; Nakajima, Toshifumi; Hirokawa, Keiko; Takada, Yoshie; Hosono, Masako; Nishita, Toshiyuki; Yamada, Ryusaku [Osaka City Univ. (Japan). Medical School

1997-03-01

115

MR imaging of uterine cervical carcinoma: comparison between fast spin-echo MRI and GRASE  

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The aim of our study was to compare the image quality of T2-weighted gradient-echo-and-spin-echo (GRASE) MRI and fast spin-echo (FSE) MRI for imaging of cervical carcinoma. In 40 patients FSE{sub 8} (TR/TE = 3400/90 ms) MRI with echo train length (ETL) of 8, GRASE (3400/90) MRI with ETL of 18, turbo factor of 6 and 3 gradient reversals, and FSE{sub 18} (2500/120) MRI with ETL of 18 were performed. Tissue contrast, subjectively rated image quality, and accuracy of tumor delineation were compared. Surgical correlation was obtained in 27 subjects. Contrast-to-noise ratios of the tumor-cervix stroma, tumor-parametrium and tumor-rectum wall interfaces were better in FSE{sub 18} than in FSE{sub 8} and GRASE (P < 0.001) but not different between FSE{sub 8} and GRASE. Subjective image quality was better in FSE{sub 18} and FSE{sub 8} than in GRASE (P < 0.02). The accuracy of tumor delineation was similar for the three different sequences. The accuracy of FSE and GRASE MRI for the delineation of cervical carcinoma is similar. Based on measurement of image quality and CNRs, however, high turbo factor FSE provides better image quality in MRI of cervical carcinoma.Whether the superior characteristics may result in better staging has to be explored in larger clinical trials. (orig.) With 3 figs., 1 tab., 11 refs.

Postema, S.; Pattynama, P.M.T.; Rijswijk, C.S.P. van; Erkel, A. van; Tjin A Ton, E.R. [Department of Radiology, Leiden University Medical Center (Netherlands)

1998-02-01

116

A consensus-based guideline defining clinical target volume for primary disease in external beam radiotherapy for intact uterine cervical cancer  

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The objective of this study was to develop a consensus-based guideline to define clinical target volume for primary disease (clinical target volume primary) in external beam radiotherapy for intact uterine cervical cancer. The working subgroup of the Japan Clinical Oncology Group (JCOG) Radiation Therapy Study Group began developing a guideline for primary clinical target volume in November 2009. The group consisted of 10 radiation oncologists and 2 gynecologic oncologists. The process started with comparing the contouring on computed tomographic images of actual cervical cancer cases among the members. This was followed by a comprehensive literature review that included primary research articles and textbooks as well as information on surgical procedures. Extensive discussion occurred in face-to-face meetings (three occasions) and frequent e-mail communications until a consensus was reached. The working subgroup reached a consensus on the definition for the clinical target volume primary. The clinical target volume primary consists of the gross tumor volume, uterine cervix, uterine corpus, parametrium, vagina and ovaries. Definitions for these component structures were determined. Anatomical boundaries in all directions were defined for the parametrium. Examples delineating these boundaries were prepared for the posterior border of the parametrium for various clinical situations (id est (i.e.) central tumor bulk, degree of parametrial involvement). A consensus-based guideline defining the clinical target volume primary was developed for external beam radiotherapy for intact uterine cervical cancer. This guideline will serve as a template for radiotherapy protocols in future clinical trials. It may also be used in actual clinical practice in the setting of highly precise external beam radiotherapy, including intensity-modulated radiotherapy. (author)

2011-09-01

117

The cytoimmunological effect of concomitant use of sizofiran (SPG) on advanced uterine cervical cancer treated with radiation  

International Nuclear Information System (INIS)

The immunological effect has been studied, using of non-specific immunopotentiator sizofiran (SPG) on the patients with advanced uterine cervical cancer treated with radiation. Ten cases (study group : SPG group) were administered weekly 40 mg of SPG through out the course of radiation and two weekly 40 mg during 12 months after radiotherapy. Nineteen cases (control group) were treated with irradiation alone. The lymphocyte count, the PHA index and the ratio of CD4 cells/CD8 cells were significantly reduced by radiotherapy, being observed the most remarkable decrease at post-radiotherapy. But in SPG group, these decreasing value were significantly smaller than in control group and the value showed a more progressive rise during the 12 month respectively. There was no significant difference in peripheral T lymphocyte ; CD3, CD4, CD8. The NK cytotoxic activity showed a progressive rise during the 12 month period following a minimal change after radiotherapy. These results suggest that the SPG have some enhancing effect on the function of the lymphocytes. (author)

1989-01-01

118

Optimal overall treatment time in fractionated radiotherapy for head and neck cancers, esophageal cancer, and uterine cervical cancer  

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The effects of overall treatment time (OTT) on local control of radiation therapy (RT) were evaluated to consider optimal OTT in RT. Local control probabilities and acute and late toxicities of esophageal cancer (Stages I-III), glottic laryngeal cancer (Stage I), and uterine cervical cancer (Stage III) treated at Kyoto University Hospital and its affiliated hospitals were analyzed in relation to OTT. For these tumors, local control probabilities decreased when OTT increased. In the multivariate analyses for esophageal cancer and laryngeal cancer, OTT was a significant variable for local control. Only a 1-week interruption of RT due to holidays resulted in a significant reduction of local control probability for T1 glottic tumors. On the other hand, there was no significant difference in local control rates between OTT of 4 weeks and 6 weeks for esophageal cancer. For complications, acute and late toxicities increased when OTT was reduced by accelerated hyperfractionated RT for esophageal cancer. In conclusion, OTT should be kept as short as possible within the limits of tolerance of normal tissues and the patients. We consider that RT must be delivered in the range of 66 to 70 Gy in 6 weeks to obtain optimal local control with minimum complications. (author). 52 refs

1996-12-01

119

Optimal overall treatment time in fractionated radiotherapy for head and neck cancers, esophageal cancer, and uterine cervical cancer  

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The effects of overall treatment time (OTT) on local control of radiation therapy (RT) were evaluated to consider optimal OTT in RT. Local control probabilities and acute and late toxicities of esophageal cancer (Stages I-III), glottic laryngeal cancer (Stage I), and uterine cervical cancer (Stage III) treated at Kyoto University Hospital and its affiliated hospitals were analyzed in relation to OTT. For these tumors, local control probabilities decreased when OTT increased. In the multivariate analyses for esophageal cancer and laryngeal cancer, OTT was a significant variable for local control. Only a 1-week interruption of RT due to holidays resulted in a significant reduction of local control probability for T1 glottic tumors. On the other hand, there was no significant difference in local control rates between OTT of 4 weeks and 6 weeks for esophageal cancer. For complications, acute and late toxicities increased when OTT was reduced by accelerated hyperfractionated RT for esophageal cancer. In conclusion, OTT should be kept as short as possible within the limits of tolerance of normal tissues and the patients. We consider that RT must be delivered in the range of 66 to 70 Gy in 6 weeks to obtain optimal local control with minimum complications. (author). 52 refs.

Nishimura, Yasumasa; Okajima, Kaoru; Hiraoka, Masahiro [Kyoto Univ. (Japan). Faculty of Medicine

1996-12-01

120

Optimum dose combination of external radiation and high dose rate ICR in FIGO stage IB uterine cervical cancer  

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Purpose: To determine the optimum dose combination scheme of external radiotherapy and high-dose-rate intracavitary radiation(HDR-ICR) to maximize tumor control with an acceptable range of late complication rate in the treatment of stage IB uterine cervical cancer. Materials and Methods: One hundred and sixty two patients with FIGO stage IB squamous cell carcinoma of uterine cervix who received definitive radiotherapy between May 1979 and December 1990 were retrospectively analyzed. All the patients received external irradiation with a total dose of 40-46 Gy in 4(1(2))-5 weeks to the whole pelvis and HDR-ICR with a total dose of 24-51 Gy in 8-17 fractions to the point A(median 39 Gy). ICR was given three times a week with a dose of 3 Gy per fraction. Midline shielding was done after 20-45 Gy of external radiotherapy(median 40 Gy). Summation of the external radiation dose and ICR dose to the point A was 64.2-95 Gy(mean 83.9 Gy). The rectal point dose was calculated at the anterior rectal wall at the level of cervical os. The local control rate, survival rate, and late complication rate were analyzed according to the irradiation dose. Results: The initial complete response rate was 99.4% for all patients. The overall 5-year survival rate and 5-year disease free survival rate were 91.1% and 90.9%, respectively. Local failure rate was 4.9% and the distant failure rate was 4.3%. The RTOG Grade I and II late complication rate was 23.5% with 18.5% presenting with rectal complications and 4.9% with bladder complications. There was no grade III or IV complication. Mean rectal dose (summation of external midline dose and ICR rectal point dose) was lower in the patients without rectal complications than those with rectal complications(74.9 Gy vs. 78.9 Gy). The late rectal complication rate was increased when the summation of the external midline dose and rectal dose by ICR was more than 70 Gy(3% for 40-59 Gy, 2% for 60-69 Gy, 10% for 70-79 Gy, 9% for 80-89 Gy, 7% for 90 Gy or more, p-value was 0.5). Late rectal complication rate was also increased without change of survival when summation of external midline dose and ICR point A dose were more than 70 Gy. Conclusions: In treating stage Ib carcinoma of uterine cervix with HDR-ICR, using 3 Gy per fraction scheme, it is crucial to keep the rectal dose not more than 70 Gy to minimize late rectal complications without compromising the survival rate. To achieve this prescription, an appropriate midline shielding during external radiation is needed

1996-09-01

 
 
 
 
121

Dose optimization of fractionated external radiation and high-dose-rate intracavitary brachytherapy for FIGO stage IB uterine cervical carcinoma  

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Purpose: To determine the optimal dose combination scheme of external beam radiotherapy (EBRT) and high-dose-rate (HDR) intracavitary radiation (ICR) for maximizing tumor control while conferring an acceptable late complication rate in the treatment of Stage IB uterine cervical cancer. Methods and Materials: We retrospectively analyzed 162 patients with International Federation of Gynecology and Obstetrics (FIGO) Stage IB squamous cell carcinoma of the uterine cervix who received definitive RT between May 1979 and December 1990. Before HDR-ICR, all patients received EBRT to a total dose of 40-46 Gy (median 45), administered during 4-5 weeks to the whole pelvis. HDR-ICR was given 3 times weeks to a total dose of 24-51 Gy (median 39) at point A, using a dose of 3 Gy/fraction. Central shielding from EBRT was begun after the delivery using 20-45 Gy (median 40) of the external dose. The total dose to point A, calculated by adding the EBRT biologically effective dose (BED) and the ICR BED to point A, was 74.1-118.1 Gy (mean 95.2). The rectal point dose was calculated at the anterior rectal wall at the level of the cervical os. The local control rate, survival rate, and late complication rate were analyzed according to the irradiation dose and BED. Results: The initial complete response rate was 99.4%. The overall 5-year survival rate and 5-year disease-free survival rate was 91.1% and 90.9%, respectively. The local failure rate was 4.9%, and the distant failure rate was 4.3%. Late complications were mild and occurred in 23.5% of patients, with 18.5% presenting with rectal complications and 4.9% with bladder complications. The mean rectal BED (the sum of the external midline BED and the ICR rectal point BED) was lower in the patients without rectal complications than in those with rectal complications (125.6 Gy vs. 142.7 Gy, p=0.3210). The late rectal complication rate increased when the sum of the external midline BED and the rectal BED by ICR was ?131 Gy (p=0.1962). However, 5-year survival rates did not increase with the external midline BED (p=0.4093). The late rectal complication rate also increased, without a change in the survival rate, when the sum of the external midline BED and the ICR point A BED was >90 Gy. Conclusion: In treating Stage IB carcinoma of the uterine cervix with HDR-ICR, using fractions of 3 Gy, it is crucial to keep the point A BED at ?90 Gy to minimize late rectal complications without compromising the survival rate. To achieve this goal, appropriate central shielding from EBRT is needed

2002-04-01

122

Central cervical fibroid mimicking as chronic uterine inversion: a case report  

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Full Text Available Leiomyomas are most common benign gynaecological tumor. Most of the fibroids are situated in the body of the uterus, but only in 1-2% cases, they are confined to cervix. We report a case of 33 years old women, para 2 live 2 diagnosed as myomatous polyp on ultrasound and clinically as chronic inversion of uterus. On surgery, we found it as central cervical fibroid with uterus sitting on the fibroid i.e. lantern on the St. Paul?s. [Int J Reprod Contracept Obstet Gynecol 2013; 2(4.000: 687-688

Swati Singh

2013-08-01

123

National survey of high-dose rate brachytherapy for uterine cervical cancer  

International Nuclear Information System (INIS)

In order to clarify the current status of treatment policies and treatment technique of high-dose rate brachytherapy practice for cervical cancer in Japan, national survey was performed in 2001. The questionnaire was sent to 215 institutions holding high and medium dose rate Remote Afterloading System (RALS), and 199 (93%) responses were received. Of these responders, 175 performed typical brachytherapy with tandem and ovoid for a total of 2,007 patients with carcinoma of the cervix in 2000. There was a wide variant in the doses used. The median external beam radiotherapy (EBRT) dose was 50 Gy and 50 Gy and the median high dose rate (HDR) dose was 25 Gy and 24 Gy for early and advanced cancers, respectively. Brachytherapy was performed weekly by 138 (82%) institutions, and twice a week by 31 (18%) institutions. The median brachytherapy dose per fraction was 6 Gy for early and advanced cancer in the case of weekly brachytherapy. On the other hand, that dose was 5 Gy in the case of twice a week. The median total treatment time was 6.5 weeks and 7 weeks for early and advanced cancers, respectively. This retrospective survey showed the current brachytherapy practice pattern in the treatment of cervical cancer in Japan. There was a variation in the brachytherapy practice pattern. We should discuss with each other about the dose evaluation method for reference volume and reference point. (author)

2004-12-01

124

Early determination of uterine cervical squamous cell carcinoma radioresponse identifies high- and low-response tumors  

International Nuclear Information System (INIS)

Purpose: To investigate whether early-assessed radioresponse of tumors corresponds with late-assessed radioresponse, which is associated with local disease control in radiotherapy (RT) for cervical cancer. Methods and Materials: This prospective study included 12 patients with cervical squamous cell carcinoma treated by RT with or without concurrent cisplatin. Tumor volume was estimated by scheduled magnetic resonance imaging before (preRT), 3 to 4 weeks after (early assessment), and 6 to 7 weeks after (late assessment) RT initiation. Radioresponse was assessed with tumor shrinkage curves based on these volumes. Radioresponse for each tumor was calculated as the slope (day-1) of the shrinkage curve by fitting to an exponential equation. Results: Early-assessed radioresponse ranged from 0.001 to 0.106 day-1 (median, 0.021 day-1) and late-assessed radioresponse from 0.009 to 0.091 day-1 (median, 0.021 day-1), with no significant difference between them (p = 0.1191). The early-assessed radioresponse correlated with the late-assessed radioresponse (R 2 = 0.714, p = 0.0005). Conclusions: Correspondence between early- and late-assessed radioresponse in a series of tumors showing a wide range of radioresponse was not particularly close overall. However, early assessment of radioresponsiveness did seem to be useful for characterizing those tumors with high or low radioresponsiveness

2006-03-15

125

Pre-invasive cervical disease and uterine cervical cancer in Brazilian adolescents: prevalence and related factors Doença cervical pré-invasiva e câncer cérvico-uterino em adolescentes brasileiras: prevalência e fatores associados  

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Full Text Available The objective was to describe the prevalence and factors associated with uterine cervical cancer (CA and high-grade squamous intraepithelial lesions (HSIL in adolescents. A cross-sectional study was carried out with 702 sexually active adolescents treated at a general hospital in Rio de Janeiro, Brazil, from 1993 to 2002. Screening was performed by cytopathology and colposcopy and confirmation by biopsy. Exposure variables were socio-demographic characteristics and those related to reproductive health, habits, and sexual behavior. Adjusted odds ratios were estimated using multivariate logistic regression analysis. Based on histopathology, the prevalence of HSIL/CA was 3% (95%CI: 1.8-4.6. There was one case of invasive cancer. With each additional pregnancy, the odds of HSIL/CA increased by 2.2 (95%CI: 1.1-4.4. Age was also associated with this outcome, doubling the odds of acquiring this degree of disease with each year of age (OR = 2.0; 95%CI: 1.2-3.4. The prevalence of lesions suggests the importance of including sexually active adolescent females in cervical cancer screening programs aimed at early detection and treatment of these lesions.O objetivo foi descrever a freqüência e os fatores associados ao câncer cervical (CA e lesões escamosas intra-epiteliais de alto grau (HSIL entre adolescentes. Realizou-se estudo transversal com 702 adolescentes sexualmente ativas, assistidas em um hospital geral no Rio de Janeiro, Brasil, entre 1993 e 2002. A investigação foi realizada através de citopatologia e colposcopia, e a confirmação por biópsia cervical. As variáveis de exposição foram características sociais e demográficas, e aquelas relacionadas à saúde reprodutiva, hábitos e comportamento sexual. Baseado nos achados histopatológicos, a freqüência de HSIL/CA foi 3% (IC95%: 1,8-4,6. Houve um caso de câncer invasivo. A cada nova gestação, a chance de HSIL/CA aumentava 2,2 vezes (IC95%: 1,1-4,4. A idade também esteve associada com este resultado (OR = 2,0; IC95%: 1,2-3,4, dobrando a cada ano de idade a chance de adquirir este nível da doença. A freqüência de lesões cervicais intra-epiteliais sugere a importância de incluir adolescentes sexualmente ativas nos programas de prevenção do câncer cervical, com o objetivo de detectar e assegurar o tratamento precoce destas lesões.

Denise Leite Maia Monteiro

2006-12-01

126

Feasibility study of an alternating schedule of radiotherapy and chemotherapy in advanced uterine cervical carcinoma  

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36 patients with advanced cervical carcinoma stage III (24 patients) and stage IV (12 patients) entered a feasibility study of a radiotherapy and chemotherapy combination. The first three chemotherapy courses consisted of cis-platinum alone and were interdigitated with radiotherapy. Six more courses composed of an association of cis-platinum and cyclophosphamide were given after the completion of radiotherapy. Radiotherapy was delivered in two courses of 25 Gy separated by a gap of 2 weeks. The overall 4-year survival rate, cumulative loco-regional failure rate, and cumulative meatstasis rate were respectively 44%, 56% and 30% in stage III and 28%, 83% and 74% in stage IV. The incidence of immediate and late complications was low: no patient had her radiotherapy stopped because of an intolerance and two patients had their chemotherapy stopped because of an haematological intolerance. Only one patient presented a severe late clinical complication (small bowel injury). 29 refs.; 2 figs.; 4 tabs

1988-01-01

127

Effects of conformation radiotherapy combined with daily intramuscular injection of bleomycin for uterine cervical cancer  

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During the period 1970-1978, 112 fresh cervical cancer patients were treated with conformation radiotherapy (60Co ?-ray). Since 1973, 2mg of Bleomycin was injected intramuscularly about 30 minutes before the irradiation in 30 cases of them (i.e. BR-therapy). The comparative prognosis for each treatment method was investigated and the following results were obtained. 1) In Stage II and III cases the incidence of the local recurrence was reduced from 32.6% with conformation radiotherapy alone to 16.7% by BR-therapy. 2) The 5 year crude survival rate for Stage III patients was 31.8% in the former group and 50.0% in the latter group. This evidence supports the view that BR-therapy is an effective treatment for the carcinoma of the cervix. (author)

1980-01-01

128

Advanced Composite of Large Cell Neuroendocrine Carcinoma and Squamous Cell Carcinoma: A Case Report of Uterine Cervical Cancer in a Virgin Woman  

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Large cell neuroendocrine carcinoma (LCNEC) of the uterine cervix is very rare and aggressive. The prognosis is very poor despite multimodal treatment. We report a virgin woman with FIGO stage 4b LCNEC of uterine cervix coexisting with squamous cell carcinoma. An early thirties virgin woman presented with 2-month history of abdominal pain. A chest X-ray showed multiple lung metastatic tumors. A vaginal smear showed malignant cells, and a biopsy specimen had features of LCNEC. The tumor showed trabecular patterns. Tumor cells possessed a moderate amount of cytoplasm, prominent nucleoli, and large nuclei. The tumor cells are stained positive for synaptophysin, chromogranin A, and neuron specific enolase (NSE). The invasive tumor cells in connection with cervical squamous epithelium were focally positive for 34bE12. We made a diagnosis of composite LCNEC and nonkeratinizing squamous cell carcinoma. High-risk HPV test was negative with hybridized captured method 2.

Kou, Iemasa; Date, Kenjiro; Nakayama, Hirofumi

2013-01-01

129

Limitation of rectal examination, CT, and MRI as a tool for diagnosing the invasion to cardinal ligaments in the uterine cervical cancers  

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The clinical methods such as pelvic (rectal) examination, CT, and MRI have been commonly used in order to detect invasion to the cardinal ligaments (CL) for determination of preoperative staging in the uterine cervical cacner. We examined the accuracy of their clinical means as for diagnosis of invasion to the CL, compared with histological findings of surgical specimens. One hundred twenty five patients with the uterine cervical cancer stage Ib or stage II who underwent a radical hysterectomy between 1987 and 1999 were enrolled in this study. When ''suspicious of invasion to the CL'' was classified as ''no invasion to the CL'' in accordance with the International Federation of Gynecology and Obstetrics (FIGO) criteria, the frequencies of bringing about the correct diagnosis was 83.2% in pelvic (rectal) examination, 76.3% in CT, and 75.0% in MRI, respectively. There was no significant difference in those among the three examinations. If suspicious of invasion to the CL'' was regarded as ''positive invasion'', the frequencies of bringing about the correct diagnosis was 84.0% in pelvic (rectal) examination, 62.2% in CT, and 63.9% in MRI. Concerning invasion to the CL, the diagnosis by pelvic (rectal) examination was significantly more accurate than that by CT as well as MRI. This result suggests that CT and MRI are not superior to pelvic examination regarding detection of the invasion to the CL in the uterine cervical cancers. (author)

Umemoto, Mika; Yokoyama, Yoshihito; Sato, Shigemi; Saito, Yoshiharu [Hirosaki Univ., Aomori (Japan). School of Medicine

2001-01-01

130

Preoperative PET/CT FDG standardized uptake value of pelvic lymph nodes as a significant prognostic factor in patients with uterine cervical cancer  

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Using integrated PET/CT, we evaluated the prognostic relevance in uterine cervical cancer of preoperative pelvic lymph node (LN) [{sup 18}F]FDG uptake. Patients with FIGO stage IB to IIA uterine cervical cancer were imaged with FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the FDG maximum standardized uptake value (SUV{sub max}) in the pelvic LN (SUV{sub LN}) on PET/CT. Clinical data, treatment modalities, and results in 130 eligible patients were reviewed. The median postsurgical follow-up was 34 months (range 6 to 109 months). Receiver operating characteristic analysis identified SUV{sub LN} 2.36 as the most significant cut-off value for predicting recurrence. SUV{sub LN} was correlated with SUV{sub tumour} (P = 0.002), primary tumour size (P = 0.004), and parametrial invasion (P = 0.013). Univariate analyses showed significant associations between recurrence and SUV{sub LN} (P = 0.001), SUV{sub tumour} (P = 0.007), pelvic LN metastasis (P = 0.002), parametrial invasion (P < 0.001), primary tumour size (P = 0.007), suspected LN metastasis on MRI (P = 0.024), and FIGO stage (P = 0.026). Multivariate analysis identified SUV{sub LN} (P = 0.013, hazard ratio, HR, 4.447, 95 % confidence interval, CI, 1.379 - 14.343) and parametrial invasion (P = 0.013, HR 6.728, 95 % CI 1.497 - 30.235) as independent risk factors for recurrence. Patients with SUV{sub LN} ?2.36 and SUV{sub LN} <2.36 differed significantly in terms of recurrence (HR 15.20, P < 0.001). Preoperative pelvic LN FDG uptake showed a strong significant association with uterine cervical cancer recurrence. (orig.)

Chung, Hyun Hoon [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea, Republic of); Cheon, Gi Jeong; Kang, Keon Wook [Seoul National University College of Medicine, Department of Nuclear Medicine, Seoul (Korea, Republic of); Kim, Jae Weon; Park, Noh-Hyun [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Song, Yong Sang [Seoul National University College of Medicine, Department of Obstetrics and Gynecology, Cancer Research Institute, Seoul (Korea, Republic of); Seoul National University, WCU Biomodulation Major, Department of Agricultural Biotechnology, College of Agriculture and Life Sciences, Seoul (Korea, Republic of)

2014-04-15

131

Preoperative PET/CT FDG standardized uptake value of pelvic lymph nodes as a significant prognostic factor in patients with uterine cervical cancer  

International Nuclear Information System (INIS)

Using integrated PET/CT, we evaluated the prognostic relevance in uterine cervical cancer of preoperative pelvic lymph node (LN) [18F]FDG uptake. Patients with FIGO stage IB to IIA uterine cervical cancer were imaged with FDG PET/CT before radical surgery. We used Cox proportional hazards regression to examine the relationship between recurrence and the FDG maximum standardized uptake value (SUVmax) in the pelvic LN (SUVLN) on PET/CT. Clinical data, treatment modalities, and results in 130 eligible patients were reviewed. The median postsurgical follow-up was 34 months (range 6 to 109 months). Receiver operating characteristic analysis identified SUVLN 2.36 as the most significant cut-off value for predicting recurrence. SUVLN was correlated with SUVtumour (P = 0.002), primary tumour size (P = 0.004), and parametrial invasion (P = 0.013). Univariate analyses showed significant associations between recurrence and SUVLN (P = 0.001), SUVtumour (P = 0.007), pelvic LN metastasis (P = 0.002), parametrial invasion (P LN (P = 0.013, hazard ratio, HR, 4.447, 95 % confidence interval, CI, 1.379 - 14.343) and parametrial invasion (P = 0.013, HR 6.728, 95 % CI 1.497 - 30.235) as independent risk factors for recurrence. Patients with SUVLN ?2.36 and SUVLN <2.36 differed significantly in terms of recurrence (HR 15.20, P < 0.001). Preoperative pelvic LN FDG uptake showed a strong significant association with uterine cervical cancer recurrence. (orig.)

2014-04-01

132

The Results of Curative Radiation Therapy for 49 Patients of the Uterine Cervical Carcinomas  

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Fifty patients with carcinoma of the uterine cervix received curative radiotherapy by external irradiation of the whole pelvis and intracavitary radiation at the Department of Therapeutic Radiology, Kangnam St. Mary Hospital from September,1983 to October, 1986. External beam whole pelvic irradiation was done first up to 4500-5940 cGy in 5 weeks to 6.5 weeks, followed by an intracavitary radiation. Total dose of radiation to point A varied from 6500 cGy to l1344 cGy (average 6764 cGy). Of the 50 patients, one patient was lost to follow up and follow up period of the remaining 49 patients ranged from 3 months to 93 months (median 32 months). According to FIGO classification, 6 (12.2%) were in stage I b, 6(12.2%) in stage I a, 25(51%) in stage II b, 7(14%) in stage III, and 5(10.2%) in stage IV. Age of the patients ranged from 33 to 76 years (Median 60 years). Pathologically, forty six(94%) patients had squamous cell carcinoma, 2 (4% had adenocarcinoma, and 1 (2%) had adenosquamous cell carcinoma. Overall response rate was 84%. 5-year survival rate was 49% for entire group (75% for stage I b, 83% for stage II a, 42.5% for stage II b, 25% for stage III, 40% for stage IV). Complications were observed in 11(22.4%) patients, who revealed rectal complications with most common frequency. Others were self limiting trifle ones such as wet desquamation, fatigue, mild leukopenia, etc. The correlation of the survival rate with various factors (age, dose, Hb level, pelvic lymph node status, performance status, local recurrence) was evaluated but showed no statistical significance except the age and local recurrence in this series; survival of patients less than 50 years of age was worse than that of the older, and the presence of local recurrence had worse prognosis(p< 0.05)

1992-12-01

133

Interfractional change of high-risk CTV D90 during image-guided brachytherapy for uterine cervical cancer.  

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The purpose of this study was to evaluate interfractional changes of the minimum dose delivered to 90% of the high-risk clinical target volume (HR-CTV D90) and D2cc of the bladder and rectum during brachytherapy for uterine cervical cancer patients. A total of 52 patients received external beam radiotherapy and high-dose-rate intracavitary brachytherapy (ICBT). For each of four ICBT applications, a pelvic CT scan was performed and the HR-CTV was delineated. Retrospectively, these patients were divided into two groups: (i) the standard dose group with 6 Gy to point A in each ICBT, and (ii) the adaptive dose group with a modified dose to point A to cover the HR-CTV with the 6-Gy isodose line as much as possible. The HR-CTV D90 was assessed in every session, and analyzed as interfractional changes. In the standard dose group, the interfractional changes of the HR-CTV D90 showed a linear increase from the first to the third of the four ICBT (average 6.1, 6.6, 7.0 and 7.1 Gy, respectively). In contrast, those of the adaptive dose group remained almost constant (average 7.2, 7.2, 7.3 and 7.4 Gy, respectively). Especially, in the case of a large HR-CTV volume (?35 cm(3)) at first ICBT, the total HR-CTV D90 of the adaptive dose group with brachytherapy was significantly higher than that of the standard dose group. There were no significant differences in total D2cc in bladder and rectum between the two groups. Image-guided adaptive brachytherapy based on interfractional tumor volume change improves the dose to the HR-CTV while keeping rectal and bladder doses within acceptable levels. PMID:23732770

Ohkubo, Yu; Ohno, Tatsuya; Noda, Shin-ei; Kubo, Nobuteru; Nakagawa, Akiko; Kawahara, Masahiro; Abe, Takanori; Kiyohara, Hiroki; Wakatsuki, Masaru; Nakano, Takashi

2013-11-01

134

Do clinicians and patients agree regarding symptoms? A comparison after definitive radiochemotherapy in 223 uterine cervical cancer patients  

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Background: In clinical cancer research of morbidity, low associations between clinician-assessed toxicity/morbidity and patient-reported symptoms are consistently described in the literature. While morbidity grading systems are supposed to follow more or less objective criteria, patient reported symptoms inherently are based on a subjective self-evaluation of the impact on quality of life. The aim of this study was to focus on major discrepancies with high clinical relevance and to evaluate its impact with regard to underreporting of morbidity. Material and methods: Early morbidity assessed by clinicians with CTCAEv.3 and patient reported quality of life (EORTC-QLQ-C30/CX24) were compared regarding 12 overlapping symptoms in 223 patients with uterine cervical cancer 3 months after definitive radio(chemo)therapy in the ongoing EMBRACE study. Mismatches showing discrepancies between both grading systems were classified, if patients reported substantial symptoms (quite a bit/very much) and CTCAE grading was rated G0. Results: In total, 360 substantial symptoms were reported by patients by EORTC-QLQ; 159 (44%) of those were not recognized by CTCAE. Symptoms with the highest occurrence of mismatches overall are urinary frequency, fatigue, and insomnia. Large institutional differences were found, showing two centers with 4 vs. 71% of patients with at least one mismatch. Conclusion: Analysis of mismatches indicated a high risk of underestimation of early morbidity. Thus, nearly half of the patient-reported substantial symptoms were not recognized by CTCAE scoring (G0) 3 months after treatment. Prospective assessment of morbidity in clinical studies should, therefore, integrate patient reported symptoms to receive a complete and comprehensive picture. (orig.)

Kirchheiner, K.; Poetter, R. [Medical Univ. Vienna (Austria). Dept. of Radiotherapy; Nout, R. [University Medical Center Leiden (Netherlands). Dept. of Clinical Oncology; Lindegaard, J. [University Hospital Aarhus (Denmark). Dept. of Oncology; Petric, P. [Institute of Oncology Ljubljana (Slovenia). Dept. of Radiotherapy; Limbergen, E.V. [University Hospital Leuven (Belgium). Dept. of Radiotherapy; Juergenliemk-Schulz, I.M. [University Medical Center Utrecht (Netherlands). Dept. of Radiation Oncology; Haie-Meder, C. [Institut Gustave-Roussy, Villejuif (France). Dept. of Radiotherapy; Doerr, W. [Technische Univ. Dresden (Germany). Dept. of Radiotherapy and Radiooncology

2012-10-15

135

Long time effect of combination therapy with irradiation and balloon-occluded arterial infusion of anti-cancer drugs on uterine cervical cancer  

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Long time effect of combination therapy with irradiation and balloon-occluded arterial infusion (BOAI) of anti-cancer drugs on uterine cervical cancer was estimated by retrospective analysis. All 73 cases received radiotherapy, while 39 cases were treated also with BOAI. Cisplatin, adriamycin and pepleomycin were administered by BOAI. In 44 stage III cases, patients with BOAI showed significantly better 5-year survival compared to radiation alone group (p=0.045). Multivariate analysis selected stage, blood hemoglobin content and BOAI as significant predictor of prognosis. No increase of late radiation damage to rectum or to urinary bladder was seen by combination therapy with BOAI. (author)

Tsuji, Ko; Shimanskaya, R.; Kojima, Akihiro [Minami-Wakayama National Hospital, Tanabe, Wakayama (Japan); Sato, Morio; Yamada, Ryusaku

1998-02-01

136

Results of hyperfractionated radiation therapy in bulky stage Ib, IIa, and IIb uterine cervical cancer  

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To evaluate the efficacy of hyperfractionated radiation therapy in carcinoma of the cervix, especially on huge exophytic and endophytic stage Ib, IIa and IIb. 41 patients with carcinoma of the cervix treated with hyperfractionated radiation therapy at the Department of Therapeutic Radiology, Dongsan Hospital, Keimyung University, School of Medicine from Jul, 1991 to Apr, 1994. Radiation therapy consisted of hyperfractionated external irradiation to the whole pelvis and boost parametrial doses (for a total of 4480-6480cGy) with midline shield (4x10cm), and combined with intracavitary irradiation (up to 7480-8520cGy in IIb to point A). The maximum and mean follow up durations were 70 and 47 months respectively. Five year local control rate was 78% and the actuarial overall five year survival rate was 66.1% for all patients, 44.4% for stage Ib, IIa and 71.4% for stage IIb. Pelvic lymph node status was significant prognostic factor affecting to five year survival rate. There was marginally significant survival difference by total dose to A point. We consider that the difference of total dose to A point by stage (mean Ib, IIa: 79Gy, IIb: 89Gy P=0.001) is one of the causes in worse local control and survival of Ib, IIa than IIb. The overall recurrence rate was 39% (16/41). The rates of local failure alone, distant failure alone, and combined local and distant failure were 9.7%, 19.5%, and 9.7%, respectively. Two patients developed leukopenia and three patients developed grade 3 gastrointestinal complication. Above grade 3 complication was not noted. There was no treatment related death noted. We considered that hyperfractionated radiation therapy may be tolerable in huge exophytic and endophytic stage IIb cervical carcinoma with acceptable morbidity and possible survival gain but this was results in small patient group and will be confirmed by long term follow up in many patients. (author)

1997-12-01

137

Concurrent Weekly Cisplatin and Radiation Therapy for High risk group of Uterine Cervical Cancer  

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Locally advanced cervical carcinoma has shown high rate of local failure and poor survival rate despite the advances in modern radiation therapy techniques. Combination of chemotherapy and radiation therapy demonstrated benefit in improving local control and possibly the overall survival. Twelve patients with advanced stages(Figo stage III, IV) or 11b with bulky tumors(>5 cm in diameter) were treated with combination of radiation therapy and concurrent weekly cisplatin between May of 1988 and September of 1991 at Inje University Paik Hospital. Cisplatin was administered in bolus injections of 50mg at weekly intervals during the courses of radiation therapy. Median follow-up period was 34 months with ranges from 3 to 53 months. Eleven patients were evaluable for the estimation of response. Response was noted in all the 11 patients: complete response(CR) in 7(64%), partial response (PR) in 4(36%). Of the 7 patients with CR, all maintained local control, whereas only 1 of 4 with PR showed local control. Six of 7 with CR are alive disease free on the completion of follow-up. Eight of 11 patients (73%) maintained local control in the pelvis. The Median survival for CR patient is 27 months and 9 months for the PR patients. Analysis of survival by stage shows 11 b 4/5, III 2/e and IV 1/3. Overall survival rate was 61%. Three patients recurred : 1 at local, 1 in distant site and 1 with local and distant site. Toxicity for the combination therapy was not excessive. These results are preliminary, but definitely encouraging in view of markedly improved response rate compared with the results of historical control group

1992-12-01

138

The diagnosis of uterine cervical polyps in a low resource setting: the positive predictive value of clinical judgment--a series of 192 cases at the Yaounde Gynaeco-Obstetric and Paediatric Hospital, Cameroon.  

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As far as we know, the accuracy of clinical judgment in diagnosing uterine cervical polyps has not been assessed in sub-Saharan Africa. Our objective was to discover the positive predictive value (PPV) of clinical judgment in the diagnosis of cervical polyps. This is a retrospective descriptive study of 192 patients, carried out by the Departments of Pathology and Gynaecology of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, Cameroon. The diagnosis of cervical polyp was confirmed by histopathology examination in 169 patients, giving a PPV rate of 88.0%. The PPV of clinical judgment in the diagnosis of cervical polyps is acceptable in our setting but the frequency of premalignant and malignant lesions encountered is too high (10.4%), even in the presence of a confirmed cervical polyp (8.9%). Even in areas where there are limited resources, we recommend a systematic histopathology examination of any clinically suspected cervical polyp. PMID:23796672

Foumane, Pascal; Sando, Zacharie; Dohbit, Julius Sama; Bilo'o, Lydienne Lesly; Mboudou, Emile Telesphore; Oyono, Jean Louis Essame

2013-04-01

139

The Frequency and Clinical Significance of Intra-amniotic Inflammation in Women With Preterm Uterine Contractility but Without Cervical Change: Do the Diagnostic Criteria for Preterm Labor Need to be Changed?  

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OBJECTIVE The objective of this study was to determine the frequency and clinical significance of intra-amniotic inflammation in patients with preterm increased uterine contractility with intact membranes but without cervical change. METHODS Amniocentesis was performed in 132 patients with regular uterine contractions and intact membranes without cervical change. Amniotic fluid was cultured for bacteria and mycoplasmas and assayed for matrix metalloproteinase-8 (MMP-8). Intra-amniotic inflammation was defined as an elevated amniotic fluid MMP-8 concentration (>23 ng/mL). RESULTS 1) Intra-amniotic inflammation was present in 12.1% (16/132); 2) Culture-proven intra-amniotic infection was diagnosed in 3% (4/132) of patients without demonstrable cervical change on admission or during the period of observation; and 3) Patients with intra-amniotic inflammation had significantly higher rates of preterm delivery and adverse outcomes, and shorter amniocentesis-to-delivery intervals than those without intra-amniotic inflammation (P < .05 for each). Adverse outcomes included chorioamnionitis, funisitis, and neonatal death. CONCLUSION Intra-amniotic inflammation was present in 12% of patients with regular uterine contractions without cervical change, while culture-proven intra-amniotic infection was present in 3%. The presence of intra-amniotic inflammation was a significant risk factor for adverse neonatal outcomes. These observations question whether cervical changes should be required for the diagnosis of preterm labor, because patients without modifications in cervical status on admission or during a period of observation are at risk for adverse pregnancy outcomes.

KIM, Sun Min; ROMERO, Roberto; LEE, JoonHo; LEE, Seung Mi; PARK, Chan-Wook; PARK, Joong Shin; YOON, Bo Hyun

2011-01-01

140

Vírus HPV e câncer de colo de útero Virus HPV y el cáncer del cuello uterino Human Papillomavirus (HPV and uterine cervical cancer  

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Full Text Available Este artigo refere-se a uma revisão de literatura sobre o vírus HPV e câncer de colo de útero, com o objetivo de levantar aspectos da infecção do vírus que influenciam no curso natural do câncer de colo de útero tais como: a tipologia do vírus, a duração e a persistência da infecção além de associar com as manifestações das lesões precursoras até a evolução da neoplasia. Foi possível constatar a forte associação da infecção com a evolução da neoplasia cervical, no entanto, ainda são necessários estudos que elucidem melhor certos aspectos da infecção do vírus HPV que agem sobre o colo do útero para que as ações de prevenção e combate a doença sejam mais eficazes.Este artículo se refiere a una revisión de literatura sobre el virus HPV y la neoplasia cervical, con el objetivo de levantar aspectos de la infección del virus que influye en el curso natural del cáncer de cuello del útero tales como: la tipologia del virus, la duración y la persistencia de la infección además de asociarlo a las manifestaciones de las lesiones precursoras hasta la evolución de la neoplasia. Ha sido posible constatar la fuerte asosiación de la infección con la evolución de la neoplasia cervical, entretanto, aún son necesarios estudios que eluciden mejor ciertos aspectos de la infección del virus HPV que actúa sobre el cuello del útero para que las acciones de prevención y combate a la enfermedad sean más eficaces.This article refers to a review of literature about the HPV virus and the cervical neoplasia, aiming at raising aspects of the virus infection which influences in the natural development of the uterine cervical cancer such as: the type of virus, the duration and the persistence of the infection and also the association with the manifestations of the preceding lesions up to the evolution of the neoplasia. It was possible to notice the strong association of the infection with the evolution of the cervical neoplasia, however, studies to better elucidate certain aspects of the infection of the HPV virus that acts on the uterine cervix are still necessary so that the actions of prevention and fight against the disease will be more efficient.

Janete Tamani Tomiyoshi Nakagawa

2010-04-01

 
 
 
 
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The role o thallium-201 whole body scan with pelvic SPECT in patients with uterine cervical treated by radiation therapy. A preliminary report  

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Evaluation of tumor extent before treatment and its response to therapy is important. The aim of this report is to assess the usefulness with thallium-201 (Tl-201) imaging study including whole body scan and pelvic single photon emission computed tomography (SPECT) in patients with uterine cervical cancers treated by radiation therapy. Before irradiation, eleven patients received detailed physical examination and Tl-201 imaging studies. A 4-score grading system was set for evaluation. The interval between Tl-201 imaging follow-up and completion of radiotherapy is one to four months, and its findings were compared with those from CT scan and clinical evidence. Before radiation, left supraclavicular and paraaortic lymphadenopathy was identified in one patient from whole body scan. Accumulation of Tl-201 uptake is observed from pelvic SPECT in all patients. It seems that patients with more tumor bulk had more intense uptake, except for one case with history of suspected pelvic inflammatory disease (PID). After radiotherapy, complete or partial regression is observed. For 6 patients with complete regression (score=0), no evidence of recurrence is confirmed by follow-up examinations. For three patients with little residual uptake (score=1), one is suspected with residual density and she is under close follow-up, the other two patients seem due to uterine myoma or short latency. These three patients received another Tl-201 scan 6 months after irradiation completion and the score became zero. One patient with residual intense uptake (score=2) suffered from relapse in the pelvis and abdomen. This preliminary report indicates that Tl-201 whole body scan and pelvic SPECT has potential in the assessment of response to radiotherapy in patients with uterine cervical cancers. However, further studies including more cases and longer follow-up are needed. (author)

2003-10-01

142

EVALUATION OF P16INK4A PROTEIN AS A BIOMARKER FOR CERVICAL INTRAEPITHELIAL NEOPLASIA AND SQUAMOUS CELL CARCINOMA OF THE UTERINE CERVIX  

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Full Text Available The association of human papilloma virus (HPV infection and cervical intraepithelial neoplasia (CIN is well known. Interaction of HPV proteins with cellular regulatory proteins leads to up regulation of p16INK4A. The aim of this study was to evaluate p16INK4A protein as a biomarker for CIN lesions and squamous cell carcinoma on biopsy specimens of patients who underwent biopsy of the uterine cervix due to abnormal cytological finding.The authors analyzed biopsies from 50 patients with CIN and invasive squamous cell carcinoma of the uterine cervix. Expression of p16INK4A in CIN and invasive squamous cell carcinoma was immunohistochemically analyzed by using monoclonal anti-p16INK4A antibody.A total of 50 patients with CIN and invasive squamous cell carcinoma of the uterine cervix (mean age 40.2±11.5 years, range 20-74 years were analyzed. CIN I lesions were found in 27 (54%, CIN II/CIN III lesions in 9 (18%, and invasive squamous cell carcinoma in 14 (28% patients. Differences in the expression of p16INK4A between CIN I, CIN II/CIN III and squamous cell carcinoma were statistically significant (p<0.0001. Expression of p16INK4A showed low sensitivity (7%, specificity (8%, positive predictive value (8%, and negative predictive value (7% for CIN I. Sensitivity, specificity, positive predictive value, and negative predictive value of p16INK4A were 78%, 61%, 30%, and 93% for CIN II/CIN III, and 100%, 75%, 61%, and 100% for squamous cell carcinoma, respectively.Results of this study suggest that p16INK4A protein may be a sensitive biomarker for CIN II/CIN III lesions and invasive squamous cell carcinoma of the uterine cervix.

Biljana ?or?evi?

2011-06-01

143

A consensus-based guideline defining the clinical target volume for pelvic lymph nodes in external beam radiotherapy for uterine cervical cancer  

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The objective of this study was to develop a consensus-based guideline as well as an atlas defining pelvic nodal clinical target volumes in external beam radiotherapy for uterine cervical cancer. A working subgroup to establish the consensus-based guideline on clinical target volumes for uterine cervical cancer was formulated by the Radiation Therapy Study Group of the Japan Clinical Oncology Group in July 2008. The working subgroup consisted of seven radiation oncologists. The process resulting in the consensus included a comparison of contouring on CT images among the members, reviewing of published textbooks and the relevant literature and a distribution analysis of metastatic nodes on computed tomography/magnetic resonance imaging of actual patients. The working subgroup defined the pelvic nodal clinical target volumes for cervical cancer and developed an associated atlas. As a basic criterion, the lymph node clinical target volume was defined as the area encompassed by a 7 mm margin around the applicable pelvic vessels. Modifications were made in each nodal area to cover adjacent adipose tissues at risk of microscopic nodal metastases. Although the bones and muscles were excluded, the bowel was not routinely excluded in the definition. Each of the following pelvic node regions was defined: common iliac, external iliac, internal iliac, obturator and presacral. Anatomical structures bordering each lymph node region were defined for six directions; anterior, posterior, lateral, medial, cranial and caudal. Drafts of the definition and the atlas were reviewed by members of the JCOG Gynecologic Cancer Study Group (GCSG). We developed a consensus-based guideline defining the pelvic node clinical target volumes that included an atlas. The guideline will be continuously updated to reflect the ongoing changes in the field. (author)

2010-05-01

144

Attendance at Cervical Cancer Screening and Use of Diagnostic and Therapeutic Procedures on the Uterine Cervix Assessed from Individual Health Insurance Data (Belgium, 2002-2006)  

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Objective To assess the coverage for cervical cancer screening as well as the use of cervical cytology, colposcopy and other diagnostic and therapeutic interventions on the uterine cervix in Belgium, using individual health insurance data. Methods The Intermutualistic Agency compiled a database containing 14 million records from reimbursement claims for Pap smears, colposcopies, cervical biopsies and surgery, performed between 2002 and 2006. Cervical cancer screening coverage was defined as the proportion of women aged 25–64 that had a Pap smear within the last 3 years. Results Cervical cancer screening coverage was 61% at national level, for the target population of women between 25 and 64 years old, in the period 2004–2006. Differences between the 3 regions were small, but varied more substantially between provinces. Coverage was 70% for 25–34 year old women, 67% for those aged 35–39 years, and decreased to 44% in the age group of 60–64 years. The median screening interval was 13 months. The screening coverage varied substantially by social category: 40% and 64%, in women categorised as beneficiary or not-beneficiary of increased reimbursement from social insurance, respectively. In the 3-year period 2004–2006, 3.2 million screen tests were done in the target group consisting of 2.8 million women. However, only 1.7 million women got one or more smears and 1.1 million women had no smears, corresponding to an average of 1.88 smears per woman in three years of time. Colposcopy was excessively used (number of Pap smears over colposcopies?=?3.2). The proportion of women with a history of conisation or hysterectomy, before the age of 65, was 7% and 19%, respectively. Conclusion The screening coverage increased slightly from 59% in 2000 to 61% in 2006. The screening intensity remained at a high level, and the number of cytological examinations was theoretically sufficient to cover more than the whole target population.

Arbyn, Marc; Fabri, Valerie; Temmerman, Marleen; Simoens, Cindy

2014-01-01

145

Glutathione s-transferase t1 and m1 polymorphisms and risk of uterine cervical lesions in women from central serbia.  

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The aim of this study was to investigate the frequencies of GSTT1 and GSTM1 deletion polymorphisms in newly-diagnosed patients with uterine cervical lesions from central Serbia. Polymorphisms of GST genes were genotyped in 97 patients with cervical lesions and 50 healthy women using a multiplex polymerase chain reaction (PCR). The GSTM1 null genotype was significantly more prominent among the patients than in controls (74.2% vs 56.0%), the risk associated with lesions being almost 2.3-fold increased (OR=2.26, 95%CI=1.10-4.65, p=0.03) and 3.17-fold higher in patients above >45 years old (95%CI=1.02-9.79, p=0.04). The analysis of the two genotypes demonstrated that GSTM1 null genotype significantly increased risk only for low grade squamous intraepithelial lesion-LSIL (OR=2.81, 95%CI=1.03-7.68, p=0.04). GSTT1 null genotype or different genotype combinations were not found to be risk factors, irrespective to lesion stages, age or smoking. We found that the risk of cervical lesions might be significantly related to the GSTM1 null genotype, especially in women aged above 45 years. Furthermore, the GSTM1 polymorphism might have greater role in development of early stage lesions. PMID:24815471

Stosic, Ivana; Grujicic, Darko; Arsenijevic, Slobodan; Brkic, Marija; Milosevic-Djordjevic, Olivera

2014-01-01

146

Análisis de expresión global del cáncer cérvico uterino: rutas metabólicas y genes alterados / Global expression analysis in uterine cervical cancer: Metabolic pathways and altered genes  

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Full Text Available SciELO Mexico | Language: Spanish Abstract in spanish La infección por virus de papiloma de alto riesgo (VPH) es considerada como el factor etiológico más importante del cáncer cérvico uterino (CaCU). Con el fin de determinar el patrón de expresión global e identificar algunos posibles genes marcadores del CaCU, se utilizaron microhileras de DNA que co [...] ntenían 8,000 secuencias que codificaban para transcritos diferentes, para estudiar los perfiles de expresión de cinco líneas celulares derivadas de CaCU, tres muestras tumorales conteniendo VPH 16 y tres muestras normales negativas para la presencia de VPH. Se identificaron los niveles de expresión de genes relacionados con diferentes rutas metabólicas. Se llevó a cabo el análisis de agrupamiento jerárquico y posteriormente se confirmó la sobrexpresión de dos genes mediante RT-PCR. Estos dos genes se encontraron sobrexpresados en biopsias tumorales cervicales. Uno de ellos, el gen de IL6, que ha sido previamente reportado en relación con CaCU, así como el gen de la matriz-metaloproteasa 10 (MMP10) por primera vez relacionado con esta neoplasia. El análisis de agrupamiento jerárquico, además, reveló que las muestras que contienen el mismo tipo viral están asociadas, sugiriendo posibles diferencias en expresión entre tipos virales. Abstract in english High risk human papillomavirus (HPV) infection is considered to be the most important etiological factor of Cervical Uterine Cancer. In order to determine the global expression pattern and to identify possible molecular markers of cervical cancer, cDNA arrays with probe sets complementary to 8,000 h [...] uman genes were used to examine the expression profiles among 5 cell lines derived from human cervical cancer, three HPV16(+) tumor samples and three normal cervical tissues HPV(-). The levels of expression of different cellular processes were identified. Hierarchical clustering was performed and the gene expression using RT-PCR was confirmed. Two genes were found to be consistently overexpressed in invasive cervical cancer biopsies; one of them, IL-6 was previously reported to be overexpressed in cervical cancer and one novel gene, MMP10, previously not known to be related to cervical cancer. Hierarchical clustering of the expression data revealed that samples with common HPV type infection grouped together, maybe this could mean that differences between HPV types could be indirectly determined by expression profiles.

Guelaguetza, Vázquez-Ortíz; Patricia, Piña-Sanchez; Alfredo, Hidalgo; Minerva, Lazos; José, Moreno; Isabel, Alvarado; Fernando, Cruz; Dulce M, Hernández; Carlos, Pérez-Plascencia; Mauricio, Salcedo.

147

Increase in rectal dose by variance in administration of Fletcher-Suit applicator during intracavitary high dose rate brachytherapy for uterine cervical cancer  

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To assess variability of the radiation dose to the rectum in manual applicator insertion for uterine cervical cancer treatment, we retrospectively surveyed the dose at the rectal evaluation point (RED) presumed in 175 planning sessions of intracavitary high dose rate brachytherapy performed in 43 patients. A wide variation was found in RED from 52 to 308% of the prescribed dose with a mean of 144%. Posterior flexure of the tandem increased RED 16% in average, and lack of vaginal gauge packing did 19%. The distance of colpostats had a significantly negative relationship with RED. In this study we found significant variation in the rectal exposure by the manual insertion procedure, and it may induce late intractable side effects. (author)

2005-12-01

148

Diagnóstico do parto pré-termo pela medida ultrassonográfica do comprimento do colo uterino Preterm labor diagnosis by sonographic measurement of the uterine cervical length  

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Full Text Available OBJETIVO: Medir o comprimento do colo uterino, utilizando a ultrassonografia transvaginal, em pacientes com quadro clínico compatível com ameaça de parto pré-termo, e correlacionar a medida do colo uterino, em cada caso, com a interrupção espontânea da gravidez dentro de sete dias. MATERIAIS E MÉTODOS: Foram realizados exames ultrassonográficos em 72 pacientes com quadro clínico compatível com ameaça de parto pré-termo. RESULTADOS: A sensibilidade do exame foi de 90,5%, a especificidade, de 98%, o valor preditivo positivo, de 95%, e o valor preditivo negativo, de 96%. A análise foi realizada utilizando-se a medida de 15 mm de comprimento do colo uterino como valor preditivo do parto pré-termo. CONCLUSÃO: Parece ser possível prever o parto pré-termo em pacientes com colo uterino menor que 15 mm. Tal observação poderá trazer contribuição para a administração mais oportuna de corticoides, com o intuito de acelerar a maturidade pulmonar fetal.OBJECTIVE: To measure the uterine cervical length by using transvaginal ultrasonography in patients with clinical signs compatible with preterm labor threat, and correlating each individual measurement with spontaneous pregnancy interruption within seven days. MATERIALS AND METHODS: Sonographic examinations were performed in 72 patients with clinical signs compatible with preterm labor threat. RESULTS: Sensitivity was 90.5%, specificity, 98%, positive predictive value, 95%, and negative predictive value, 96%. A standard uterine cervix length of 15 mm was considered as a predictive value for preterm labor. CONCLUSION: It seems to be possible to foresee preterm delivery in patients whose cervical length is < 15 mm. Such observation could contribute to a timely corticosteroid administration to accelerate fetal lung maturity.

Carlos Eduardo Ferreira Novaes

2009-10-01

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Diagnóstico do parto pré-termo pela medida ultrassonográfica do comprimento do colo uterino / Preterm labor diagnosis by sonographic measurement of the uterine cervical length  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Medir o comprimento do colo uterino, utilizando a ultrassonografia transvaginal, em pacientes com quadro clínico compatível com ameaça de parto pré-termo, e correlacionar a medida do colo uterino, em cada caso, com a interrupção espontânea da gravidez dentro de sete dias. MATERIAIS E MÉTOD [...] OS: Foram realizados exames ultrassonográficos em 72 pacientes com quadro clínico compatível com ameaça de parto pré-termo. RESULTADOS: A sensibilidade do exame foi de 90,5%, a especificidade, de 98%, o valor preditivo positivo, de 95%, e o valor preditivo negativo, de 96%. A análise foi realizada utilizando-se a medida de 15 mm de comprimento do colo uterino como valor preditivo do parto pré-termo. CONCLUSÃO: Parece ser possível prever o parto pré-termo em pacientes com colo uterino menor que 15 mm. Tal observação poderá trazer contribuição para a administração mais oportuna de corticoides, com o intuito de acelerar a maturidade pulmonar fetal. Abstract in english OBJECTIVE: To measure the uterine cervical length by using transvaginal ultrasonography in patients with clinical signs compatible with preterm labor threat, and correlating each individual measurement with spontaneous pregnancy interruption within seven days. MATERIALS AND METHODS: Sonographic exam [...] inations were performed in 72 patients with clinical signs compatible with preterm labor threat. RESULTS: Sensitivity was 90.5%, specificity, 98%, positive predictive value, 95%, and negative predictive value, 96%. A standard uterine cervix length of 15 mm was considered as a predictive value for preterm labor. CONCLUSION: It seems to be possible to foresee preterm delivery in patients whose cervical length is

Carlos Eduardo Ferreira, Novaes; Hilton Augusto, Koch; Carlos Antônio Barbosa, Montenegro; Jorge Fonte de, Rezende Filho.

150

Adjuvant radiotherapy following radical hysterectomy and bilateral pelvic lymph node dissection for the uterine cervical cancer: prognostic factors and failure patterns  

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To identify variable prognostic factors and analyse failure patterns in the uterine cervix cancer after radical operation and adjuvant radiotherapy, a retrospective analysis was undertaken. I analysed one hundred and twenty four patients with uterine cervix cancer, FIGO stage IB, IIA and IIB, treated with radical hysterectomy and pelvic lymph node dissection followed by adjuvant radiotherapy between May 1985 and May 1994. Minimum follow up period was 24 months. All of them were treated with full dose external radiotherapy with linear accelerator and/or high dose rate intracavitary radiation. Overall 5 year survival rate and relapse free survival rate were 75.4%, 73.5%, respectively. Significant prognostic factors by relapse free survival were wall involvement thickness, lymph node location and number, parametrium involvement, tumor size, stage, uterine body involvement, vaginal resection margin involvement. By multivariate analysis, lymph node metastasis, tumor size and vaginal resection margin involvement were significant prognostic factors. Treatment related failure were 33 cases. Locoregional failure were more likely in the stage IIB, lymph node positive or vaginal resection margin positive patients whereas distant failures were relatively more frequent in stage IB, IIA and lymph node, vaginal resection negative patients. In stage IIB, 5 year relapse free survival rate was only 56% and nine of twenty two patients recurred. Postoperative radiotherapy results are good for patients with relatively low risk factor. But the results are poor for patients with multiple, high risk factors or stage IIB. To control recurrence for patients with high risk factors, postoperative adjuvant radiotherapy is not sufficient treatment method. To raise control rate, adding other methods such as radiosensitizing agent or chemotherapy is necessary and prospectively randomized study is needed for evaluation of postoperative radiotherapy efficacy and/or other methods. And it is reasonable to treat primary radical radiotherapy for patients with stage IIB cervical cancer instead of radical operation and adjuvant radiotherapy and/or chemotherapy regimen. (author).

Choi, D. H. [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

1997-12-01

151

Características clínico patológicas del cáncer de cérvix uterino recurrente después de cirugía radical primaria. / Clinical and pathological features of recurrent uterine cervical cancer after primary radical surgery  

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Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Objetivo: Describir las características clínico patológicas del cáncer de cérvix uterino recurrente, sitio y tiempo de recurrencia, y sobrevida después de la recurrencia de acuerdo a las variables de pronóstico en pacientes con cirugía radical primaria. Material y métodos: Estudio descriptivo, obser [...] vacional y retrospectivo, tipo serie de casos, realizado en el Instituto Nacional de Enfermedades Neoplásicas de Lima Perú entre 1990 y 2005. Se incluyeron todas las pacientes con cáncer de cérvix uterino estadios IB1 y IIA a quienes se les realizó cirugía radical primaria y que tuvieron recurrencia. Las curvas de sobrevida fueron construidas con el método de Kaplan-Meier. Resultados: Se realizaron 609 histerectomías radicales tipo III, 53(8,7%) tuvieron recurrencia. La edad promedio al diagnóstico de la recurrencia fue 44,5 años, el tiempo medio desde la cirugía hasta la recurrencia 18,9 meses y el sitio de recurrencia más frecuente fue a distancia (41,5%) seguido por recurrencia central y pélvica. El sitio de recurrencia y los márgenes quirúrgicos tuvieron significancia estadística con respecto al tiempo de recurrencia. La terapia de salvataje más frecuente fue la radioterapia (45%). La sobrevida promedio después de la recurrencia fue 26,9 meses y la tasa de sobrevida a 5 años 9,4%. Conclusiones: El cáncer cervical recurrente es poco frecuente, afecta a mujeres jóvenes y el sitio de recurrencia más frecuente es metástasis a distancia. El tiempo de recurrencia es más corto cuando la recurrencia es central y los márgenes quirúrgicos están afectados. La sobrevida después de la recurrencia en cáncer cervical tratado con cirugía radical es baja. Abstract in english Objective: To describe clinical and pathological features of recurrent uterine cervical cancer, including site and time to recurrence and survival after primary radical surgery. Methods: Descriptive, observational case series study conducted at the Instituto Nacional de Enfermedades Neoplásicas in L [...] ima between 1990 and 2005. Patients with recurrent uterine cervical cancer stages IB1 and IIA who had been treated with primary surgical resection were included. Kaplan-Meir survival curves were constructed. Results: 609 radical hysterectomies type II were performed; 53 (8.7%) had a recurrence. Mean age at diagnosis of recurrence was 44.5 years; mean time from surgery to recurrence was 18.9 months, and the most common site for recurrence was distant recurrence (415%), followed by central recurrence and pelvic recurrence. Site of recurrence and surgical margins had statistical association with time to recurrence. The most frequent salvage therapy was radiotherapy (45%). Mean survival time after recurrence was 26.9 months, and survival rate at 5 years was 9.4%. Conclusions: Recurrent uterine cervical cancer is not frequent, its affects young females causing distant metastasis mainly. Time to recurrence is shorter when recurrence is central and surgical margins are involved. Survival time after recurrence in patients treated surgically is short.

Pedro, Aguilar; Henry, Valdivia.

152

Does supplementing dairy cows with ?-carotene during the dry period affect postpartum ovarian activity, progesterone, and cervical and uterine involution?  

Science.gov (United States)

?-carotene is the main natural precursor of vitamin A and plays an important role in reproductive efficiency and immune function in dairy cows. The objective of this study was to investigate whether a supplement of ?-carotene given during the dry period is able to 1) increase blood concentrations of ?-carotene postpartum, 2) improve ovarian function and progesterone production, and 3) enhance uterine involution and uterine health. This study was conducted using 40 Holstein cows. On the day of drying-off, cows were allocated to one of two dietary treatments: control diet (C, n = 20) or control diet plus 1g/d ?-carotene (BC, n = 20). The ?-carotene supplement was given individually to the cows until calving. Blood samples were obtained regularly before and after calving from the cows to measure the concentrations of ?-carotene. The diameters of the cervix and uterine horns were measured regularly using ultrasonography. Endometrial cytology samples were acquired from the cervix and uterus to determine uterine health. Milk samples were obtained three times per week for progesterone assay. Additional blood samples were taken on the day of calving, 7 and 21 days postpartum to determine the plasma concentrations of amino acids. Blood concentrations of ?-carotene were not different before the start of the experiment (C, 3.03 ± 0.22 mg/L vs BC, 3.12 ± 0.22 mg/L, P > 0.05). Blood concentrations of ?-carotene in the BC group peaked (7.45 ± 0.24 mg/L) 1 month after drying-off while the concentrations in the C group remained constant. ?-carotene concentrations then decreased in both groups. The difference in blood concentrations of ?-carotene between groups became significant 2 weeks after the start of the supplement until 2 weeks postpartum. There was no significant difference in the interval from calving to ovulation between groups (C, 27.8 ± 3.46 d vs BC, 35.8 ± 3.55 d, P > 0.05). The dietary supplement of ?-carotene during the dry period had no effect on ovarian activity, progesterone production, cervix and uterine horn diameters. Plasma concentrations of hydroxyproline in the BC group were higher than in the C group on day 21 postpartum (BC, 20.8 ± 1.33 ?mol/L vs C, 15.0 ± 1.33 ?mol/L; P uterine involution may have been more complete and that uterine inflammation may have been reduced in cows which received the ?-carotene compared to controls. PMID:21196044

Kaewlamun, W; Okouyi, M; Humblot, P; Techakumphu, M; Ponter, A A

2011-04-01

153

Detección y tipificación de virus papiloma humano en lesiones preneoplásicas de cuello uterino Human papillomavirus genotyping of cervical uterine preneoplastic lesions in a high risk area  

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Full Text Available The relationship between human papillomavirus (HPV and uterine cervical cancer (UCC is widely known and accepted. Aim: To determine the frequency of genotypes of HPV in cervical preneoplastic lesions in a high risk area of UCC. Material and Methods: Using a combination of PCR and Reverse Line Blot technique, 235 formalin fixed paraffin embedded samples, with diagnosis of low-grade squamous intraepithelial lesion (LSIL or high-grade squamous intraepithelial lesion (HSIL were genotyped. Results: HPV was detected in 61.2% of LSIL and 78.1% of HSIL. The main genotypes found were HPV 16, 18, 31, 45, 56 y 58. HPV 16 was the most common in both LSIL (18.1% and HSIL (36.9%. HPV 16 or 18 were present in 25.1% and 47.1% of the LSIL and HSIL respectively. In both LSIL and HSIL, the predominant viral genotypes were those types classified as with a high oncogenic risk. Conclusions: HPV genotypes 16, 18, 31, 45, 56 y 58 were the most common in our series. HPV 16 and 18, viral types with high oncogenic risk and included in commercial vaccines, were found in 25.1% and 47.1% of LSIL and HSIL, respectively.

JAIME LÓPEZ M

2010-11-01

154

Screening for uterine tumours.  

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The most prevalent uterine tumours are leiomyomas, which are benign and have a prevalence of about 50% at menopause. The incidence of endometrial cancer and uterine sarcomas is about 25 per 100,000 and 0.7 per 100,000, respectively. Reported risk factors for endometrial cancer are advanced age, unopposed oestrogen stimulation, late menopause, obesity, diabetes mellitus, nulliparity, feminising ovarian tumours, polycystic ovarian syndrome, tamoxifen and belonging to a hereditary non-polyposis colorectal cancer family. Unopposed oestrogen stimulation and tamoxifen have also been confirmed to induce uterine sarcomas. Cervical cytology, endometrial sampling and ultrasound have been proposed in the early diagnosis of endometrial cancer. No pathognomonic ultrasound, magnetic resonance imaging or computed tomography features are able to differentiate between a leiomyoma and a uterine sarcoma, and reliable serum markers for sarcomas are lacking. To date, mass screening for uterine malignancies is not feasible or effective. PMID:22078749

Van den Bosch, Thierry; Coosemans, An; Morina, Memli; Timmerman, Dirk; Amant, Frederic

2012-04-01

155

Studies on combined effect of irradiation with CDDP and BLM in cultured cells from uterine cervical cancer  

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The purpose is to examine the combined effect of irradiation with anticancer drugs on uterine cancer, SKG-IIIb cells, cultured from squamous cell carcinoma of uterine cervix, were used in this study. Anticancer drugs were CDDP 1 {mu}g/ml, BLM 10 {mu}g/ml, and the radiation was {sup 60}Co 0.5 Gy. The results were as follows: The growth of cells was the most strongly suppressed by the exposure to radiation after CDDP administration. By the exposure to radiation after anticancer drugs administration, the morphorogic damage of cells was revealed both by a light microscope and a scanning electron microscope. Flow cytometric measurement revealed that anticancer drugs changed DNA distributions of cells: the accumulation of exposed cells in S phase was showed and the cell cycle progression was delayed. DNA histograms showed no accumulation of cells in G{sub 2}{sup +}M phase that were most effective phase to irradiation in 24 hours after anticancer drugs administration, but partial synchronization in G{sub 2}{sup +}M phase in 48 hours after BLM administration. These results indicate that the combined therapy of anticancer drugs and irradiation on uterine cancer is effective and timely irradiation will be more effective. (author).

Kato, Hiroaki (Tottori Univ., Yonago (Japan). School of Medicine)

1989-11-01

156

Studies on combined effect of irradiation with CDDP and BLM in cultured cells from uterine cervical cancer  

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The purpose is to examine the combined effect of irradiation with anticancer drugs on uterine cancer, SKG-IIIb cells, cultured from squamous cell carcinoma of uterine cervix, were used in this study. Anticancer drugs were CDDP 1 ?g/ml, BLM 10 ?g/ml, and the radiation was 60Co 0.5 Gy. The results were as follows: The growth of cells was the most strongly suppressed by the exposure to radiation after CDDP administration. By the exposure to radiation after anticancer drugs administration, the morphorogic damage of cells was revealed both by a light microscope and a scanning electron microscope. Flow cytometric measurement revealed that anticancer drugs changed DNA distributions of cells: the accumulation of exposed cells in S phase was showed and the cell cycle progression was delayed. DNA histograms showed no accumulation of cells in G2+M phase that were most effective phase to irradiation in 24 hours after anticancer drugs administration, but partial synchronization in G2+M phase in 48 hours after BLM administration. These results indicate that the combined therapy of anticancer drugs and irradiation on uterine cancer is effective and timely irradiation will be more effective. (author)

1989-01-01

157

Conocimientos sobre prevención del cáncer cérvico-uterino en los adolescentes Knowledge on the prevention of the cervical-uterine cancer in the adolescents  

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Full Text Available En Cuba, al igual que en el resto de los países occidentales, el cáncer cérvico-uterino se encuentra en segundo lugar de morbilidad oncológica en mujeres de 20 a 30 años; y a ctualmente está considerado como una infección de transmisión sexual. Hay estudios que revelan información deficiente por parte de los adolescentes en cuanto a las infecciones de transmisión sexual y sus consecuencias. Es por ello, que en el período comprendido entre febrero y noviembre de 2009 se realizó una investigación descriptiva con el objetivo de identificar los conocimientos sobre prevención del cáncer cérvico-uterino en los adolescentes de la ESBU Manuel Sanguily, del municipio Matanzas. El universo estuvo integrado por los alumnos de noveno grado, y para la selección de la muestra se utilizó un muestreo probabilístico por conglomerados monoetápico. Se aplicó un cuestionario, cuyos resultados relevantes indicaron que los varones iniciaron sus primeras relaciones sexuales a los 13 años y las hembras a las edades de 13 y 14 años, representado un 57,1 % y 50 %, respectivamente. Solo el 12,7 % de los adolescentes identificó al virus del papiloma humano como factor de riesgo en la génesis del cáncer cérvico-uterino. El bajo nivel de conocimientos para la prevención de este tipo de cáncer predominó en el 92,7 % de la muestra. Se concluye que en el grupo de adolescentes estudiados, lo más frecuente fue el inicio temprano de las relaciones sexuales, tanto para varones como para hembras, aunque estas últimas representaron solo el 10 %. Se identificó desconocimiento sobre el virus del papiloma humano como agente causal de esta morbilidad, y pobre conocimiento sobre cómo prevenirlo.In Cuba, as in the rest of the Western countries, the cervical-uterine cancer is in the second place of oncologic morbidity in 20-to-30 years-old women; currently it is considered a sexually transmitted infection. There are some studies revealing deficient information on the part of the teenagers as for the sexually transmitted diseases and theirs consequences. That is why, in the period from February to November 2009 we carried out a descriptive investigation with the objective of identifying the knowledge on the prevention of the cervical-uterine cancer the students of the Secondary School Manuel Sanguily, Municipality of Matanzas, have. The universe was formed by the nine grade students, and to select the sample we used a probabilistic sampling by mono-stage conglomerates. A questionnaire was applied and the results indicated that the males began their first sexual relationships to the 13 years and the females to the ages of 13 and 14 years, representing 57,1 % and 50 %, respectively. Only 12,7 % of the teenagers identified the human papilloma virus as a risk factor in the genesis of the cervical-uterine cancer. The low level of knowledge for the prevention of this kind of cancer prevailed in 92,7 % of the sample. We concluded that in the group of teenagers we studied, the most frequent fact was that they began early having sexual relationships, both boys and girls, although the last ones represented only 10 %. We identified ignorance on the human papilloma virus and poor knowledge about how to prevent it as the casual agent of this morbidity.

Regla Mercedes García Rosique

2011-04-01

158

La promoción de salud dirigida a reducir los factores de riesgo de cáncer cérvico uterino / Health promotion aimed to reducing uterine cervical cancer risk factors  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish La primera Conferencia Internacional sobre la Promoción de la Salud celebrada en Ottawa, el 21 de noviembre de 1986, definió la promoción de la salud como “el proceso de permitir a la gente aumentar su control sobre su salud y por lo tanto mejorarla”. Se reconoce claramente que la promoción de la sa [...] lud va más allá de los estilos de vida, en la cual la educación para la salud constituye, junto a la comunicación y a la participación social, herramientas necesarias para su instrumentación en el primer nivel de atención. En la práctica cotidiana se desconoce de forma reiterada el valor que tiene el reconocimiento adecuado de las dimensiones de la promoción de salud, desde una perspectiva holística, dirigidas a reducir los factores de riesgo de cáncer cérvico uterino. El propósito del estudio fue realizar una contribución teórica a la promoción de salud para contribuir al fortalecimiento del Programa Nacional de Diagnóstico Precoz del Cáncer Cérvico Uterino. Al considerar el valor de esta disciplina desde sus dimensiones, el profesional de la salud dispone de una base teórica que guíe las acciones dirigidas a la reducción de factores de riesgos de este tipo de cáncer en la población femenina. Abstract in english The first International Conference on Health Promotion celebrated in Ottawa on November 21st, 1986, defined health promotion as “the process allowing people to increase the control on their health and therefore to improve it”. It is clearly understood that health promotion goes beyond life styles, a [...] nd also includes education for health, communication and social participation, necessary tools for its instrumentation in the first health care level. In every day practice it is continually not recognized the value of the adequate acknowledgement of health promotion dimensions, from a holistic perspective, aimed to reducing the uterine cervical cancer risk factors. The purpose of the research was theoretically contributing to the strengthening of the National Program of Uterine Cervical Cancer Precocious Diagnosis. When considering the value of this discipline in all its dimensions, the health care professional has a theoretical base to guide the actions aimed to reducing the risk factors of this kind of cancer among the female population.

Misleny, Martínez Pérez; Juan Carlos, de la Concepción Cárdenas; Ariel, Pérez González.

159

A Dose-Volume Analysis of Magnetic Resonance Imaging-Aided High-Dose-Rate Image-Based Interstitial Brachytherapy for Uterine Cervical Cancer  

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Purpose: To investigate the feasibility of our novel image-based high-dose-rate interstitial brachytherapy (HDR-ISBT) for uterine cervical cancer, we evaluated the dose-volume histogram (DVH) according to the recommendations of the Gynecological GEC-ESTRO Working Group for image-based intracavitary brachytherapy (ICBT). Methods and Materials: Between June 2005 and June 2007, 18 previously untreated cervical cancer patients were enrolled. We implanted magnetic resonance imaging (MRI)-available plastic applicators by our unique ambulatory technique. Total treatment doses were 30-36 Gy (6 Gy per fraction) combined with external beam radiotherapy (EBRT). Treatment plans were created based on planning computed tomography with MRI as a reference. DVHs of the high-risk clinical target volume (HR CTV), intermediate-risk CTV (IR CTV), and the bladder and rectum were calculated. Dose values were biologically normalized to equivalent doses in 2-Gy fractions (EQD2). Results: The median D90 (HR CTV) and D90 (IR CTV) per fraction were 6.8 Gy (range, 5.5-7.5) and 5.4 Gy (range, 4.2-6.3), respectively. The median V100 (HR CTV) and V100 (IR CTV) were 98.4% (range, 83-100) and 81.8% (range, 64-93.8), respectively. When the dose of EBRT was added, the median D90 and D100 of HR CTV were 80.6 Gy (range, 65.5-96.6) and 62.4 Gy (range, 49-83.2). The D2cc of the bladder was 62 Gy (range, 51.4-89) and of the rectum was 65.9 Gy (range, 48.9-76). Conclusions: Although the targets were advanced and difficult to treat effectively by ICBT, MRI-aided image-based ISBT showed favorable results for CTV and organs at risk compared with previously reported image-based ICBT results.

2010-07-01

160

Quality assurance in the prospective multi-institutional trial on definitive radiotherapy using high-dose-rate intracavitary brachytherapy for uterine cervical cancer. The individual case review  

International Nuclear Information System (INIS)

The objective of this study was to assess compliance with the radiotherapy protocol of a multi-institutional prospective study (JAROG0401/JROSG04-2), which investigated the efficacy and toxicity of definitive radiotherapy using high-dose-rate intracavitary brachytherapy (HDR-ICBT) for early-stage uterine cervical cancer patients. Individual case reviews (ICRs) were performed on all 60 study participants. Radiotherapy data were submitted to the quality assurance (QA) committee, which performed ICRs on 16 QA items according to previously selected criteria. The items focused on quality of external beam radiotherapy (EBRT), HDR-ICBT and both. Each item was determined to be either acceptable or a deviation. The QA committee performed ICR three times as planned, two during the patient accrual and the final one just after the final patient accrued. The QA results of the first and second reviews were reported back to the investigators after each ICR. In 40 cases (67%), all 16 QA items were classified as acceptable. One deviation was found in 16 cases, two deviations were identified in 3 cases and three deviations were noted in 1 case. The most frequently observed deviation was missing the rules for determining point A (10 cases). The items described by quantitative values, such as prescribed doses, certain time intervals and overall treatment time, were well followed. The proportion of deviations gradually decreased during the ICR process. The present ICR demonstrated the favorable radiotherapy compliance with the JAROG0401/JROSG04-2 protocol. The QA process using ICRs can potentially be used to improve the quality of radiotherapy, including HDR-ICBT in the multi-institutional prospective studies for cervical cancer. (author)

2009-12-01

 
 
 
 
161

[Three cases of uterine cervical adenocarcinoma successfully treated by neoadjuvant chemotherapy with continuous intra-arterial infusion (cisplatin, 5-fluorouracil)].  

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Low-dose consecutive intra-arterial infusion therapy with cisplatin and 5-fluorouracil as neoadjuvant chemotherapy was performed on 3 cases of cervical adenocarcinoma (two stage IIb and one stage IIIb). Ten-day infusion of cisplatin 10 mg/day (one shot) and 5-fluorouracil 250 mg/day (continuous) into blood flow-altered bilateral internal iliac arteries, was carried out as one course and 2 times at intervals of 3 weeks. As a result, side effects were slight, and all of these 3 cases showed a tumor diminution rate of above 83.5%, making it possible to perform complete tumorectomy through radical hysterectomy. However, some postoperative additional treatment was thought to be necessary, considering that with the present method, the area under the curve of free Pt of cubital venous blood is 2.4 mg hr/l and that by the present method alone long-term survival cannot be expected in cervical adenocarcinoma. PMID:8546460

Narimatsu, A; Okada, O

1996-01-01

162

The Effect of Cyclooxygenase-2 Expression on Tumor Volume Response in Patients Treated with Radiotherapy for Uterine Cervical Cancer  

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We investigated the correlation between Cyclooxygenase-2 (COX-2) expression and the tumor response in patients with cervical cancer that were treated with curative radiotherapy (RT). Fifty-seven patients with squamous cell carcinoma were treated with concurrent radiochemotherapy (CRCT, n=29) or RT alone (n=28). The response of each patient was evaluated by three serial Magnetic Resonance Imaging examinations: before the start of RT, at four weeks after the start of RT (mid-RT) and at four wee...

Kang, Min Kyu; Park, Won; Choi, Yoon-la; Cho, Eun Yoon; Ahn, Geunghwan; Nam, Heerim; Huh, Seung Jae; Ahn, Yong Chan; Lim, Do Hoon; Oh, Dong Ryul; Bae, Duk Soo; Kim, Byoung Gie

2009-01-01

163

Protein p 16INK4A expression in cervical intraepithelial neoplasia and invasive squamous cell carcinoma of uterine cervix  

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Full Text Available The association of human papilloma virus (HPV infection and cervical intraepithelial neoplasia (CIN is well recognized. Interaction of HPV oncogenic proteins with cellular regulatory proteins leads to up regulation of p16 INK4A , a CDK inhibitor, which is a biomarker for HPV infection. We investigated p16 expression in CIN and invasive squamous cell carcinoma (SCC which has not been reported in the Indian population previously. Materials and Methods: Retrospective analysis of 100 cases with 20 cases each of histologically normal cervical epithelium, CIN1, 2, 3 and invasive SCC for p16 expression was performed by immunohistochemistry using commercially available mouse monoclonal antibody to p16 (clone 6H12. Statistical Analysis: For differences in expression among groups, statistical analysis was carried out using ANOVA and post hoc test of Scheffe. Results: p16 immunoreactivity was found to be both nuclear and/or cytoplasmic. The normal cervical epithelium was predominantly negative for p16 (18/20. There was a progressive increase of p16 expression with the grade of CIN. In CIN 1, two cases (20% showed nuclear and nucleocytoplasmic positivity respectively. In contrast, diffuse strong nuclear or nucleocytoplasmic expression was observed in 45 and 55% cases of CIN 2 and CIN 3 respectively. All except one squamous cell carcinoma stained strongly positive for p16. The difference in expression between CIN 2/3 and SCC versus normal cervix was found highly significant (p is equal to 0.008 and p less than 0.001. Conclusions: p16 expression correlates excellently with the grade of CIN and is a sensitive marker of cervical intraepithelial neoplasia.

Gupta Ruchi

2010-01-01

164

Efficacy of cone biopsy of the uterine cervix during frozen section for the evaluation of cervical intraepithelial neoplasia grade 3.  

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We retrospectively selected 22 cases in which patients with a biopsy-proven diagnosis of cervical intraepithelial neoplasia grade 3 underwent cervical conization for frozen section (FS) evaluation followed by hysterectomy at the University of California Irvine Medical Center, Orange, during the August 1995 to September 9, 2001. All slides from FS and permanent section (PS) and hysterectomy specimens were reviewed. FS diagnoses were compared with those of previous biopsies, PS, and hysterectomy specimens. The PS correlated with FS in all cases but 1. Appropriate surgery was performed for all patients based on FS diagnosis. The McNemar test was used to compare the results of FS and PS, with a 2-sided P value of 1.0 and a c coefficient of 0.7755 with a 95% confidence level, indicating that the 2 groups were not significantly different. FS evaluation of cervical conization is as efficacious and accurate as evaluation of regular specimens in providing information for the appropriateness of same-day surgery. We recommend that entire tissue be submitted for FS to avoid sampling errors and to increase diagnostic accuracy. PMID:15362368

Gu, Mai; Lin, Fritz

2004-09-01

165

Unstable chromosome aberrations on peripheral blood lymphocytes from patients with cervical uterine cancer following radiotherapy; Aberracoes cromossomicas instaveis em linfocitos de pacientes com cancer de colo de utero  

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Absorbed dose determination is an important step for risk assessment related to an exposure to ionizing radiation. However, physical dosimetry cannot be always performed, principally in the case of retrospective estimates. In this context, the use of bioindicators (biological effects) has been proposed, which defines the so-called biological dosimetry. In particular, scoring of unstable chromosomes aberrations (dicentrics, centric rings and fragments) of peripheral blood lymphocytes, while is the most reliable biological method for estimating individual exposure to ionizing radiation. In this work, blood samples from 5 patients, with cervical uterine cancer, were evaluated after partial-body radiotherapy with a source of {sup 69} Co. For this, conventional cytogenetic method was employed, based on Giemsa coloration and fluorescence in situ hybridization, in order to correlate the frequency of unstable chromosome aberrations of blood lymphocytes with absorbed dose, as a result of the radiotherapy. A good agreement was observed between the frequency of chromosome aberrations scored and the values of dose previously calculated by physical dosimetry during patient's radiotherapy. The results presented in this work point out the importance of concerning analyses of unstable chromosome aberrations as biological dosimeter in the investigation of partial-body exposure to ionizing radiation. (author)

Magnata, Simey de Souza Leao Pereira

2002-09-01

166

Tendência da mortalidade por câncer do útero no Município de São Paulo entre 1980 e 1999 Mortality trends from uterine cervical cancer in the city of São Paulo from 1980 to 1999  

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Full Text Available O câncer do colo do útero apresenta grande incidência em algumas cidades brasileiras e considerável mortalidade em países em desenvolvimento, não obstante a disponibilidade já antiga de teste de rastreamento. O presente estudo visou avaliar a tendência da mortalidade por câncer de colo do útero, de corpo do útero e por câncer do útero não especificado, no Município de São Paulo, entre 1980 e 1999, por meio do exame das taxas brutas, idade-específica e ajustadas por idade. Os resultados mostraram discreta redução da mortalidade por câncer do colo do útero, queda da mortalidade por câncer de útero não especificado e aumento da mortalidade por câncer do corpo do útero. Conclui-se que a queda da mortalidade por câncer do útero não especificado sinaliza uma melhora na precisão do diagnóstico clínico e na qualidade do preenchimento do atestado de óbito, e indica aumento de cobertura do teste de Papanicolaou.Uterine cervical cancer shows a higher incidence in some Brazilian cities. It is a common cause of death in women from developing countries, despite the longstanding availability of an effective screening test, the Pap smear. This study aimed to evaluate the temporal trends of crude, age-adjusted, and age-specific mortality rates from cervical cancer, endometrial cancer, and cancer of the uterus not otherwise specified (NOS in the city of São Paulo from 1980 to 1999. Results showed a slight reduction in cervical cancer rates, a decrease in NOS uterine cancer rates, and an increase in endometrial cancer mortality rates. The fall in mortality from NOS uterine cancer indicates an improvement in diagnostic accuracy and quality of information on death certificates and may point to an increase in coverage of cervical cancer screening using the Pap smear.

Luiz Augusto Marcondes Fonseca

2004-02-01

167

Tendência da mortalidade por câncer do útero no Município de São Paulo entre 1980 e 1999 / Mortality trends from uterine cervical cancer in the city of São Paulo from 1980 to 1999  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O câncer do colo do útero apresenta grande incidência em algumas cidades brasileiras e considerável mortalidade em países em desenvolvimento, não obstante a disponibilidade já antiga de teste de rastreamento. O presente estudo visou avaliar a tendência da mortalidade por câncer de colo do útero, de [...] corpo do útero e por câncer do útero não especificado, no Município de São Paulo, entre 1980 e 1999, por meio do exame das taxas brutas, idade-específica e ajustadas por idade. Os resultados mostraram discreta redução da mortalidade por câncer do colo do útero, queda da mortalidade por câncer de útero não especificado e aumento da mortalidade por câncer do corpo do útero. Conclui-se que a queda da mortalidade por câncer do útero não especificado sinaliza uma melhora na precisão do diagnóstico clínico e na qualidade do preenchimento do atestado de óbito, e indica aumento de cobertura do teste de Papanicolaou. Abstract in english Uterine cervical cancer shows a higher incidence in some Brazilian cities. It is a common cause of death in women from developing countries, despite the longstanding availability of an effective screening test, the Pap smear. This study aimed to evaluate the temporal trends of crude, age-adjusted, a [...] nd age-specific mortality rates from cervical cancer, endometrial cancer, and cancer of the uterus not otherwise specified (NOS) in the city of São Paulo from 1980 to 1999. Results showed a slight reduction in cervical cancer rates, a decrease in NOS uterine cancer rates, and an increase in endometrial cancer mortality rates. The fall in mortality from NOS uterine cancer indicates an improvement in diagnostic accuracy and quality of information on death certificates and may point to an increase in coverage of cervical cancer screening using the Pap smear.

Fonseca, Luiz Augusto Marcondes; Ramacciotti, Adriana de Souza; Eluf Neto, José.

168

Tendência da mortalidade por câncer do útero no Município de São Paulo entre 1980 e 1999 / Mortality trends from uterine cervical cancer in the city of São Paulo from 1980 to 1999  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Portuguese Abstract in portuguese O câncer do colo do útero apresenta grande incidência em algumas cidades brasileiras e considerável mortalidade em países em desenvolvimento, não obstante a disponibilidade já antiga de teste de rastreamento. O presente estudo visou avaliar a tendência da mortalidade por câncer de colo do útero, de [...] corpo do útero e por câncer do útero não especificado, no Município de São Paulo, entre 1980 e 1999, por meio do exame das taxas brutas, idade-específica e ajustadas por idade. Os resultados mostraram discreta redução da mortalidade por câncer do colo do útero, queda da mortalidade por câncer de útero não especificado e aumento da mortalidade por câncer do corpo do útero. Conclui-se que a queda da mortalidade por câncer do útero não especificado sinaliza uma melhora na precisão do diagnóstico clínico e na qualidade do preenchimento do atestado de óbito, e indica aumento de cobertura do teste de Papanicolaou. Abstract in english Uterine cervical cancer shows a higher incidence in some Brazilian cities. It is a common cause of death in women from developing countries, despite the longstanding availability of an effective screening test, the Pap smear. This study aimed to evaluate the temporal trends of crude, age-adjusted, a [...] nd age-specific mortality rates from cervical cancer, endometrial cancer, and cancer of the uterus not otherwise specified (NOS) in the city of São Paulo from 1980 to 1999. Results showed a slight reduction in cervical cancer rates, a decrease in NOS uterine cancer rates, and an increase in endometrial cancer mortality rates. The fall in mortality from NOS uterine cancer indicates an improvement in diagnostic accuracy and quality of information on death certificates and may point to an increase in coverage of cervical cancer screening using the Pap smear.

Fonseca, Luiz Augusto Marcondes; Ramacciotti, Adriana de Souza; Eluf Neto, José.

169

Results of radiotherapy for stage III uterine cervical carcinomas and preliminary study of combined radiotherapy and transarterial infusion chemotherapy  

International Nuclear Information System (INIS)

This is a retrospective analysis of 55 patients with stage III carcinoma of the uterine cervix treated with radiation from November 1984 through December 1991. Eleven of the patients were treated with radiation and transarterial infusion chemotherapy (TAI), using cis-platinum and pepleomycin. The 3- and 5-year cumulative survival rates for all patients were 61% and 58%, respectively, and the 3-year cumulative survival rate for the group with combined radiation and TAI was 47%. According to initial failure site, the locoregional recurrence rate was 36.8%, and that for para-aortic lymph node metastasis and distant metastasis was 31.6%. The failure pattern was similar between the irradiation only group and the group with combined radiation and TAI. The incidence of intestinal complications of grades 1 and 2 was 20%. Irradiation combined with TAI did not increase the incidence of complications. (author)

1994-11-01

170

Mulheres vivenciando o adoecer em face do câncer cérvico-uterino Mujeres que viven la experiencia de enfermedad en la presencia de cáncer cervical-uterino Women living the experience of illness in the presence of cervical-uterine cancer  

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Full Text Available O câncer cérvico-uterino é uma doença de alta incidência e prevalência no país. Com este estudo objetivou-se compreender as vivências de mulheres em face do processo de adoecer por câncer cérvico-uterino. Estudo descritivo exploratório realizado durante o primeiro trimestre de 2002 em serviço de referência ao atendimento de neoplasias de Fortaleza-CE. Foram pesquisadas vinte mulheres com câncer cérvico-uterino mediante entrevista semi-estruturada, cujas respostas foram assim categorizadas: 1. barreiras que dificultaram a prevenção; 2. enfrentamentos: da consulta ao diagnóstico de câncer; 3. desconhecimento sobre a evolução da doença; e 4. apego às pessoas e à religiosidade. Segundo evidenciaram os resultados, a maioria era proveniente do interior do Estado, com idade entre 30 e 50 anos; 75% possuíam ensino médio; 85% viviam com um a dois salários mínimos e 45% não haviam realizado o Papanicolaou. Diante da doença, indicaram sentimentos como ansiedade, medo e pânico. Também referiram desinformação e disseram recorrer à religião como estratégia para enfrentar o câncer. Alguns fatores de risco foram mencionados, sobressaindo: ausência e não adesão ao exame preventivo, convívio com escassos recursos socioeconômicos e dificuldades de acesso aos serviços de saúde.El cáncer cervical-uterino es una enfermedad de incidencia alta y predominio en Brasil. El objetivo del estudio presente era entender qué mujeres experimentan al enfrentar el proceso de volverse la deuda enferma al cáncer cervical-uterino. Un estudio exploratorio descriptivo se llevó a cabo en el primer trimestre de 2002 a una referencia repare para el cuidado de cáncer en Fortaleza-CE. Se investigaron veinte mujeres con el cáncer cervical-uterino por medio de una entrevista semi-estructurada, con las contestaciones a categorizándose como sigue: 1. barreras que dañan la prevención; 2. cubriendo: de la visita al diagnóstico de cáncer; 3. falte de conocimiento sobre el curso de la enfermedad; y 4. la atadura a las personas y a la religiosidad. Los resultados mostraron que la mayoría de las mujeres era del interior del Estado y era 30 a 50 años viejo; 75% tenían la media educación escolar; 85% vivieron encendido a dos salario mínimo, y 45% no habían sometido a una prueba de Papanicolaou. Al enfrentar la enfermedad, ellos indicaron sentimientos de ansiedad, miedo y pánico. Ellos también informaron falta de información y declararon que ellos se repitieron a la religión como una estrategia cubrir con el cáncer. Algunos factores de riesgo fueron mencionados, el más importante entre ellos: la ausencia de un examen preventivo o falta de complacencia con él, viviendo con las personas de recursos socio-económicos escasos, y dificultad de acceso a los servicios de salud.Cervical-uterine cancer is a disease of high incidence and prevalence in Brazil. The objective of the present study was to understand what women experience when facing the process of becoming ill due to cervical-uterine cancer. A descriptive exploratory study was carried out in the first trimester of 2002 at a reference service for cancer care in Fortaleza-CE. Twenty women with cervical-uterine cancer were investigated by means of a semi-structured interview, with the responses being categorized as follows: 1. barriers that impair prevention; 2. coping: from the visit to the diagnosis of cancer; 3. lack of knowledge about the course of the disease; and 4. attachment to people and to religiosity. The results showed that most women were from the interior of the State and were 30 to 50 years old; 75% had middle school education; 85% lived on one to two minimum wages, and 45% had not submitted to a Papanicolaou test. When facing the disease, they indicated feelings of anxiety, fear and panic. They also reported lack of information and stated that they recurred to religion as a strategy to cope with cancer. Some risk factors were mentioned, the most important among them: absence of a preventive examination or lack of compliance wi

Mariza Silva de Oliveira

2005-06-01

171

Mulheres vivenciando o adoecer em face do câncer cérvico-uterino / Women living the experience of illness in the presence of cervical-uterine cancer / Mujeres que viven la experiencia de enfermedad en la presencia de cáncer cervical-uterino  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O câncer cérvico-uterino é uma doença de alta incidência e prevalência no país. Com este estudo objetivou-se compreender as vivências de mulheres em face do processo de adoecer por câncer cérvico-uterino. Estudo descritivo exploratório realizado durante o primeiro trimestre de 2002 em serviço de ref [...] erência ao atendimento de neoplasias de Fortaleza-CE. Foram pesquisadas vinte mulheres com câncer cérvico-uterino mediante entrevista semi-estruturada, cujas respostas foram assim categorizadas: 1. barreiras que dificultaram a prevenção; 2. enfrentamentos: da consulta ao diagnóstico de câncer; 3. desconhecimento sobre a evolução da doença; e 4. apego às pessoas e à religiosidade. Segundo evidenciaram os resultados, a maioria era proveniente do interior do Estado, com idade entre 30 e 50 anos; 75% possuíam ensino médio; 85% viviam com um a dois salários mínimos e 45% não haviam realizado o Papanicolaou. Diante da doença, indicaram sentimentos como ansiedade, medo e pânico. Também referiram desinformação e disseram recorrer à religião como estratégia para enfrentar o câncer. Alguns fatores de risco foram mencionados, sobressaindo: ausência e não adesão ao exame preventivo, convívio com escassos recursos socioeconômicos e dificuldades de acesso aos serviços de saúde. Abstract in spanish El cáncer cervical-uterino es una enfermedad de incidencia alta y predominio en Brasil. El objetivo del estudio presente era entender qué mujeres experimentan al enfrentar el proceso de volverse la deuda enferma al cáncer cervical-uterino. Un estudio exploratorio descriptivo se llevó a cabo en el pr [...] imer trimestre de 2002 a una referencia repare para el cuidado de cáncer en Fortaleza-CE. Se investigaron veinte mujeres con el cáncer cervical-uterino por medio de una entrevista semi-estructurada, con las contestaciones a categorizándose como sigue: 1. barreras que dañan la prevención; 2. cubriendo: de la visita al diagnóstico de cáncer; 3. falte de conocimiento sobre el curso de la enfermedad; y 4. la atadura a las personas y a la religiosidad. Los resultados mostraron que la mayoría de las mujeres era del interior del Estado y era 30 a 50 años viejo; 75% tenían la media educación escolar; 85% vivieron encendido a dos salario mínimo, y 45% no habían sometido a una prueba de Papanicolaou. Al enfrentar la enfermedad, ellos indicaron sentimientos de ansiedad, miedo y pánico. Ellos también informaron falta de información y declararon que ellos se repitieron a la religión como una estrategia cubrir con el cáncer. Algunos factores de riesgo fueron mencionados, el más importante entre ellos: la ausencia de un examen preventivo o falta de complacencia con él, viviendo con las personas de recursos socio-económicos escasos, y dificultad de acceso a los servicios de salud. Abstract in english Cervical-uterine cancer is a disease of high incidence and prevalence in Brazil. The objective of the present study was to understand what women experience when facing the process of becoming ill due to cervical-uterine cancer. A descriptive exploratory study was carried out in the first trimester o [...] f 2002 at a reference service for cancer care in Fortaleza-CE. Twenty women with cervical-uterine cancer were investigated by means of a semi-structured interview, with the responses being categorized as follows: 1. barriers that impair prevention; 2. coping: from the visit to the diagnosis of cancer; 3. lack of knowledge about the course of the disease; and 4. attachment to people and to religiosity. The results showed that most women were from the interior of the State and were 30 to 50 years old; 75% had middle school education; 85% lived on one to two minimum wages, and 45% had not submitted to a Papanicolaou test. When facing the disease, they indicated feelings of anxiety, fear and panic. They also reported lack of information and stated that they recurred to religion as a strategy to cope with cancer. So

Mariza Silva de, Oliveira; Ana Fátima Carvalho, Fernandes; Marli Teresinha Gimeniz, Galvão.

172

Cytodiagnosis of cervical smears and serum levels of carcinoembryonic antigen (CEA) following radiation therapy for cancer of the uterine cervix  

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Serum levels of carcinoembryonic antigen (CEA) were serially determined and cytodiagnosis of cervical smears was made in 6 patients with advanced squamous cell cancer of the cervix (aged from 66 to 81 years) undergoing radiation therapy. In a patient with an elevated pretreatment serum level of CEA, serial CEA levels tended to decrease with increasing radiation doses, but cytodiagnostic findings remained unchanged. In the other 5 patients with normal or slightly elevated pretreatment serum levels of CEA, cytodiagnostic findings improved in response to radiation doses. In one of the 6 patients, CEA of the tumor cells was stained well in association with the elevated serum CEA level, suggesting some relationship between serum CEA levels and atypical tumor cells exposed to x-rays. Serum CEA determinations are thus considered useful in the follow-up of cancer patients treated by radiation therapy. (Namekawa, K.)

1985-01-01

173

Multi-institutional study of radiation therapy for isolated para-aortic lymph node recurrence in uterine cervical carcinoma: 84 subjects of a population of more than 5,000  

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Purpose: Most patients who had any recurrent sites of cancer have been considered to be in their last stage of life. However, recent advances of clinical research reveal some patients achieve long-term survival even in recurrence. Furthermore, for patients who had only one recurrent region, radiation therapy could play an important role. As for uterine cervical carcinoma, the most common recurrent site other than the pelvis is the para-aortic lymph nodes. Thus we conducted the current study. Patients and Methods: Between 1994 and 2003, more than 5,000 uterine cervical carcinoma patients were treated with curative intended treatments at 13 Japanese hospitals. Of these patients, 84 developed para-aortic lymph node recurrence as the only site of initial tumor progression. These patients were treated with external beam radiation therapy. Radiation therapy protocol was as follows: 1.7-2.0 Gy per fraction, 5 fractions per week, and the mean total dose was 50.8 Gy (25-60 Gy). Results: Three- and 5-year overall survival rates of all patients were 49.5% and 31.3%, respectively. Stratified by symptom sign, 3-year overall survival rate of symptom positive was 27.6% and those of the negative was 56.1% (p = 0.018). Three-year overall survival rates of the total dose ?51 Gy and that of ?50 Gy were 58.0% and 42.8%, respectively (p = 0.07). As for morbidity, no patients received Grade 3 or greater late toxicity. Conclusions: The current study suggested that radiation therapy for isolated para-aortic lymph node recurrence in uterine cervical carcinoma could have a significant impact on survival

2006-12-01

174

Changes in tumor oxygen tension during radiotherapy of uterine cervical cancer: relationships to changes in vascular density, cell density, and frequency of mitosis and apoptosis  

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Purpose: Changes in oxygen tension (pO2) during the early phase of fractionated radiotherapy were studied in 22 patients with uterine cervical cancer. The aims were to investigate (a) whether possible changes in pO2 differed among and within tumors and (b) whether the changes could be attributed to changes in vascular density, cell density, and frequency of mitosis and apoptosis. Methods and Materials: The pO2 was measured polarographically in four regions of the tumors before treatment and after 2 weeks of radiotherapy. The vascular density, cell density, and frequency of mitosis and apoptosis were determined from biopsies taken from the tumor regions after each pO2 measurement. Results: The changes in pO2 during therapy differed among the tumors and were correlated to pO2 before treatment (p 2 and vice versa. The tumors with increased pO2 (n = 10) had a large decrease in cell density and a significant increase in apoptotic frequency. In contrast, the tumors with decreased pO2 (n = 10) had a smaller decrease in cell density (p = 0.014) and no significant increase in apoptotic frequency. Vascular density and mitotic frequency showed no change during therapy; however, vascular damage other than decreased vascular density was observed. Conclusion: These results indicate that the oxygenation of cervix tumors generally changes during the early phase of radiotherapy. The change depends on the balance between the factor leading to an increase and that leading to a decrease in oxygenation; i.e., decreased cell density and vascular damage, respectively. Increased apoptotic frequency may contribute to a large decrease in cell density and hence increased oxygenation during therapy

2000-03-01

175

Ganglio centinela para estadios tempranos en cáncer de cuello uterino / Sentinel lymph node detection in early uterine cervical cancer  

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Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Objetivo: Determinar la factibilidad y seguridad del ganglio centinela (GC) con el uso combinado del mapeo linfático con Tc 99 y la inyección de colorante azul (patent blue) en pacientes con cáncer de cérvix temprano sometidas a histerectomía radical con linfadenectomía pélvica bilateral. Diseño: Es [...] tudio prospectivo. Institución: Instituto Nacional de Enfermedades Neoplásicas, Lima, Perú. Participantes: Pacientes con cáncer temprano de cuello uterino. Intervenciones: Entre diciembre de 2003 y diciembre de 2006, 66 pacientes con cáncer temprano de cuello estadios IA2 (n=2), IB1 (n=63) y IIA (n=1) fueron sometidas a detección del ganglio linfático centinela con linfoscintigrafía el día previo a la operación y mapeo linfático intraoperatorio con colorante azul y sonda detectora de radiación gama. El tratamiento quirúrgico se completó con la realización de la histerectomía radical y linfadenectomía pélvica bilateral, por laparotomía. Principales medidas de resultados: Detección de ganglios centinelas. Resultados: En las 66 pacientes estudiadas se detectó 136 ganglios centinelas, con un promedio de 2,06 por paciente. Se utilizó el método combinado (Tc 99 y patent blue). La localización más frecuente fue la región obturatriz con un 69,9% (n=95). Se halló metástasis en los ganglios pélvicos en 11 pacientes, que fueron correctamente localizadas en el ganglio centinela con una sensibilidad de 100%. Cuando el ganglio centinela fue negativo, no se encontró metástasis en los ganglios no centinela (VPN 100%). Conclusiones: La identificación del ganglio centinela con tecnecio-99 combinado con la inyección de colorante azul es factible y mostró un valor predictivo negativo de 100%. Abstract in english Objective: To determine sentinel node (SN) detection feasibility and safety by using lymphatic mapping with 99m Tc Dextrán and injection of blue dye (patent blue) in patients with early cervical cancer undergoing radical hysterectomy with bilateral pelvic lymphadenectomy. Design: Prospective study. [...] Setting: Instituto Nacional de Enfermedades Neoplasicas, Lima, Peru. Participants: Patients with early cervical cancer. Interventions: Between December 2003 and December 2006, 66 patients with early cervical cancer stages IA2 (n = 2), IB1 (n = 63) and IIA (n = 1) underwent sentinel lymph node detection with lymphoscintigraphy the day before operation and intraoperative lymphatic mapping with blue dye and gamma radiation detection probe. Surgical treatment was completed with radical hysterectomy and bilateral pelvic lymphadenectomy by laparotomy. Main outcome measures: Sentinel node detection. Results: One hundred and thirty-six sentinel nodes were detected in all 66 patients, average 2.06 per patient, by using the combined method 99m Tc dextrán and patent blue. Most common location was the obturator region in 69.9% of cases (n = 95). Pelvic lymph node metastases were found by the sentinel node in 11 patients (sensitivity of 100%). In negative sentinel node cases (55 patients) no metastases were encountered (negative predictive value, NPV = 100%). Conclusions: Sentinel node identification using 99m technetium Dextrán and blue dye injection is feasible and had a negative predictive value of 100%.

Henry, Valdivia; Rossana, Morales; Luis, Taxa; Manuel, Álvarez; Carlos, Santos; Albert, Zevallos; Carlos, Velarde; Marco, Sánchez; Aldo, López; Absalón, Montoya.

176

Evolution of uterine cervical cancer mortality from 1979 to 1998 in the State of Rio Grande do Sul, Brazil A evolução da mortalidade por câncer de colo de útero entre 1979 e 1998 no Rio Grande do Sul, Brasil  

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A decrease in uterine cervical cancer (CC) mortality has been observed in developed countries. However, mortality data in Brazil suggest that CC is one of the most frequent causes of cancer death in women; it is the fourth cause of death from cancer in women in Rio Grande Sul State. A time-trend ecological study was performed to analyze CC mortality trends in Rio Grande do Sul from 1979 to 1998. Data were collected from the Mortality Information System, Brazilian Ministry of Health (DATASUS)....

2005-01-01

177

Critérios de positividade para cervicografia digital: melhorando a sensibilidade do diagnóstico do câncer cervical / Digital cervicography criteria: improving sensitivity in uterine cervical cancer diagnosis  

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Full Text Available SciELO Public Health | Language: Portuguese Abstract in portuguese O objetivo deste trabalho foi validar critérios de positividade para cervicografia digital. Estudo realizado com 300 mulheres submetidas a protocolo clínico composto por exame citológico, uma avaliação por meio de cervicografia digital sem ampliação de imagem (Avaliação 1), e outra avaliação também [...] usando cervicografia digital mas com ampliação adicional de imagem e os critérios de positividade propostos neste estudo (Avaliação 2). A idade média das mulheres foi de 27,6 anos. Os critérios de positividade para cervicografia digital foram identificados em 111 casos (100%) dos testes positivos para lesões precursoras do câncer do colo uterino e em 8 casos (2,6%) considerados falso-positivos. As avaliações 1 e 2 classificaram os exames como positivos (163; 54,3%) e suspeitos (146; 48,6%), respectivamente. Os resultados revelam que a cervicografia digital foi mais sensível (99,1%) e a citologia mais específica (100%). O desempenho alcançado pela cervicografia digital, quando aplicado os critérios de positividade, alcançou sensibilidade 4,5 vezes superior ao desempenho da citologia oncológica, além do baixo custo, sugerindo ser uma técnica factível. Abstract in english This study aimed to validate the scoring criteria for digital cervicography. The study enrolled 300 women submitted to a clinical protocol using cytological examination alone, digital cervicography without image magnification (Evaluation 1), and digital cervicography plus additional image magnificat [...] ion and considering the positive criteria (Evaluation 2). Women's mean age was 27.6 years. Positive criteria for digital cervicography were identified in 111 positive cases with pre-cancerous cervical lesions (100%) and in 8 cases classified as false positives (2.6%). Evaluations 1 and 2 classified the tests as positive (163; 54.3%) and suspected (146; 48.6%), respectively. According to the findings, digital cervicography was more sensitive (99.1%) and cytology more specific (100%). Digital cervicography sensitivity increased by 4.5 times when the positive criteria were applied as compared to cytology alone, besides involving low cost, thus suggesting that it is a viable technique.

Eugênio Santana, Franco; Silvia Bomfim, Hyppólito; Rosana Gomes de Freitas Menezes, Franco; Mônica Oliveira Batista, Oriá; Paulo César de, Almeida; Lorita Marlena Freitag, Pagliuca; Nelson Fernando Pacheco da, Rocha.

178

Critérios de positividade para cervicografia digital: melhorando a sensibilidade do diagnóstico do câncer cervical / Digital cervicography criteria: improving sensitivity in uterine cervical cancer diagnosis  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O objetivo deste trabalho foi validar critérios de positividade para cervicografia digital. Estudo realizado com 300 mulheres submetidas a protocolo clínico composto por exame citológico, uma avaliação por meio de cervicografia digital sem ampliação de imagem (Avaliação 1), e outra avaliação também [...] usando cervicografia digital mas com ampliação adicional de imagem e os critérios de positividade propostos neste estudo (Avaliação 2). A idade média das mulheres foi de 27,6 anos. Os critérios de positividade para cervicografia digital foram identificados em 111 casos (100%) dos testes positivos para lesões precursoras do câncer do colo uterino e em 8 casos (2,6%) considerados falso-positivos. As avaliações 1 e 2 classificaram os exames como positivos (163; 54,3%) e suspeitos (146; 48,6%), respectivamente. Os resultados revelam que a cervicografia digital foi mais sensível (99,1%) e a citologia mais específica (100%). O desempenho alcançado pela cervicografia digital, quando aplicado os critérios de positividade, alcançou sensibilidade 4,5 vezes superior ao desempenho da citologia oncológica, além do baixo custo, sugerindo ser uma técnica factível. Abstract in english This study aimed to validate the scoring criteria for digital cervicography. The study enrolled 300 women submitted to a clinical protocol using cytological examination alone, digital cervicography without image magnification (Evaluation 1), and digital cervicography plus additional image magnificat [...] ion and considering the positive criteria (Evaluation 2). Women's mean age was 27.6 years. Positive criteria for digital cervicography were identified in 111 positive cases with pre-cancerous cervical lesions (100%) and in 8 cases classified as false positives (2.6%). Evaluations 1 and 2 classified the tests as positive (163; 54.3%) and suspected (146; 48.6%), respectively. According to the findings, digital cervicography was more sensitive (99.1%) and cytology more specific (100%). Digital cervicography sensitivity increased by 4.5 times when the positive criteria were applied as compared to cytology alone, besides involving low cost, thus suggesting that it is a viable technique.

Eugênio Santana, Franco; Silvia Bomfim, Hyppólito; Rosana Gomes de Freitas Menezes, Franco; Mônica Oliveira Batista, Oriá; Paulo César de, Almeida; Lorita Marlena Freitag, Pagliuca; Nelson Fernando Pacheco da, Rocha.

179

The effect of cyclooxygenase-2 expression on tumor volume response in patients treated with radiotherapy for uterine cervical cancer.  

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We investigated the correlation between Cyclooxygenase-2 (COX-2) expression and the tumor response in patients with cervical cancer that were treated with curative radiotherapy (RT). Fifty-seven patients with squamous cell carcinoma were treated with concurrent radiochemotherapy (CRCT, n=29) or RT alone (n=28). The response of each patient was evaluated by three serial Magnetic Resonance Imaging examinations: before the start of RT, at four weeks after the start of RT (mid-RT) and at four weeks after the completion of RT (post-RT). Forty-three patients had positive COX-2 expression. The COX-2 negative patients achieved a higher rate of complete response (CR) at mid-RT than did the COX-2 positive patients (28.6% vs. 7.0%, P=0.054), but not at post-RT (64.3% vs. 69.8%). The initial tumor volume was a significant predictor of CR at mid-RT (P=0.003) and post-RT (P=0.004). The multivariate analysis showed that the initial tumor volume (at mid-RT and post-RT) and CRCT (at post-RT) were significant predictors of CR; however, the COX-2 expression was not. In conclusion, the COX-2 expression status has no significant correlation with the tumor response. Further studies on the changes in COX-2 expression levels during RT may be helpful for determination of its role in the tumor response to treatment and patient prognosis. PMID:19949677

Kang, Min Kyu; Park, Won; Choi, Yoon-La; Cho, Eun Yoon; Ahn, Geunghwan; Nam, Heerim; Huh, Seung Jae; Ahn, Yong Chan; Lim, Do Hoon; Oh, Dong Ryul; Bae, Duk Soo; Kim, Byoung Gie

2009-12-01

180

Comparison of tumor regression rate of uterine cervical squamous cell carcinoma during external beam and intracavitary radiotherapy  

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We compared the radioresponse of cervical carcinoma that was closely related to local disease control by the tumor regression rate (RR) during intracavitary radiotherapy (ICRT) and external beam radiotherapy (EBRT) on the presumption that ICRT has a stronger treatment impact than EBRT because of its specific dose distribution. A total of 37 patients were treated by EBRT at 45.0 Gy over 5 weeks, followed by high-dose-rate ICRT at 6.0 Gy per weekly insertion at point A three to five times and by boost EBRT. RR was defined as the slope (day-1) of the tumor-volume shrinkage curve fit to an exponential regression equation. Assuming that the tumors were ellipsoid, the tumor volume was estimated using magnetic resonance (MR) images obtained before treatment, after 45.0 Gy of EBRT, and after the third ICRT insertion. RRs were compared based on the radiotherapy method. RR ranged between -0.008 to 0.093 day-1 (median 0.021 day-1) during EBRT and -0.001 to 0.097 day-1 (median 0.018 day-1) during ICRT, showing no significant difference or correlation between treatments. Contrary to expectations, RR did not directly relate to the impact of physical treatment. RR could be related to biological factors, such as the amount of tumor clearance and changes in tumor consistency during treatment. (author)

2008-11-01

 
 
 
 
181

Uterine peaking – sonographic sign of vesico-uterine adhesion  

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Full Text Available Objective: In this paper we present our observation of a specific sign on transvaginal ultrasound that may help basic minimal invasive surgeons diagnose vesico-uterine adhesions preoperatively. Methods: The ultrasound images of the latest eleven patients who were preoperatively diagnosed with vesico-uterine adhesions using transvaginal ultrasound were compared with their intraoperative findings. Results: Ultrasonography showed a spectrum of changes from obliterated anterior cul-de-sac to dense fibrosis between the lower uterine segment and cervix with the bladder. Horn- or beak-shaped streaks of tissue with the same density of uterine myometrium is a sign of fundal attachment of vesico-uterine adhesions or of complete anterior cul-de-sac obliteration with adhesions going between the uterus and the anterior abdominal wall. Fine papillary peaking is seen in cases of dense lower uterine segment and cervical fibrosis without fundal involvement. These signs combined with limited mobility of the cervix and bladder base correlated with the presence of dense vesico-uterine adhesions. Conclusion: The described sonographic signs, two static and the other dynamic, may help basic minimal invasive gynecological surgeons who do not have advanced laparoscopic skills and do not feel comfortable dealing with an obliterated anterior cul-de-sac or dense vesico-uterine space fibrosis predict the presence of dense vesico-uterine adhesions allowing them to choose another route that they may be more comfortable with such as vaginal or abdominal hysterectomy or request assistance from a more experienced colleague.

Heaton, Richard L.

2011-01-01

182

PET in uterine malignancies  

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Full Text Available Positron Emission Tomography (PET or integrated PET/Computed Tomography (PET/CT with 18F-Fluoro-Deoxy-Glucose (18F-FDG is a functional imaging modality, useful in the characterization of undetermined morphological findings, and in the staging/re-staging of a large number of malignancies. Although its use in uterine malignancies has been poorly investigated, in recent years the employment of this technique has constantly increased. In this review, we evaluate the role of PET (/CT with 18FFDG in uterine malignancies (cervical and endometrial cancers as well as uterine sarcomas, underlying its advantages and discussing its limitations. Metabolic and anatomic information given by PET/CT with 18F-FDG could be useful in the evaluation of local and distant disease involvement at the staging, in the detection of disease recurrence, and in the evaluation of the response after chemotherapy and/or radio-therapy.

Valeria Pirro

2010-07-01

183

Optimum radiotherapy schedule for uterine cervical cancer based-on the detailed information of dose fractionation and radiotherapy technique  

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The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of 23.4 {approx} 59.4 Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-ICBT) was also performed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of 14.4{approx} 43.2 Gy (Median 36.0) of EBRT in 495 patients, while in the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder and rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor ({alpha} / {beta} = 10) and late-responding tissues ({alpha} /{beta} = 3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED Gy{sub 3} and the risk of complication was assessed using serial multiple logistic regressions models. The associations between R-BED Gy{sub 3} and rectal complications and between V-BED Gy{sub 3} and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED Gy{sub 10} and the treatment duration. The overall complication rate for RTOG Grades 1 {approx} 4 toxicities was 33.1%. The 5-year actuarial pelvic control rate for all 743 patients was 83%. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 Gy{sub 10} (median 93.0) for tumors and from 93.6 to 187.3 Gy{sub 3} (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED Gy{sub 3}) and bladder point BED (V-BED Gy{sub 3}) were 118.7 Gy{sub 3} (range 48.8 {approx} 265.2) and 126.1 Gy{sub 3} (range: 54.9{approx} 267.5), respectively. MD-BED Gy{sub 3} showed a good correlation with rectal ({rho} =0.003), but not with bladder complications ({rho} = 0.095), R-BED Gy{sub 3} had a very strong association ({rho} = <0.0001), and was more predictive of rectal complications than A-BED Gy{sub 3}, B-BED Gy{sub 3} also showed significance in the prediction of bladder complications in a trend test ({rho} = 0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences in tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity f

Cho, Jae Ho; Kim, Hyun Chang; Suh, Chang Ok [Yonsei University Medical School, Seoul (Korea, Republic of)] (and others)

2005-09-15

184

Optimum radiotherapy schedule for uterine cervical cancer based-on the detailed information of dose fractionation and radiotherapy technique  

International Nuclear Information System (INIS)

The best dose-fractionation regimen of the definitive radiotherapy for cervix cancer remains to be clearly determined. It seems to be partially attributed to the complexity of the affecting factors and the lack of detailed information on external and intra-cavitary fractionation. To find optimal practice guidelines, our experiences of the combination of external beam radiotherapy (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT) were reviewed with detailed information of the various treatment parameters obtained from a large cohort of women treated homogeneously at a single institute. The subjects were 743 cervical cancer patients (Stage IB 198, IIA 77, IIB 364, IIIA 7, IIIB 89 and IVA 8) treated by radiotherapy alone, between 1990 and 1996. A total external beam radiotherapy (EBRT) dose of 23.4 ? 59.4 Gy (Median 45.0) was delivered to the whole pelvis. High-dose-rate intracavitary brachytherapy (HDR-ICBT) was also performed using various fractionation schemes. A Midline block (MLB) was initiated after the delivery of 14.4? 43.2 Gy (Median 36.0) of EBRT in 495 patients, while in the other 248 patients EBRT could not be used due to slow tumor regression or the huge initial bulk of tumor. The point A, actual bladder and rectal doses were individually assessed in all patients. The biologically effective dose (BED) to the tumor (? / ? = 10) and late-responding tissues (? /? = 3) for both EBRT and HDR-ICBT were calculated. The total BED values to point A, the actual bladder and rectal reference points were the summation of the EBRT and HDR-ICBT. In addition to all the details on dose-fractionation, the other factors (i.e. the overall treatment time, physicians preference) that can affect the schedule of the definitive radiotherapy were also thoroughly analyzed. The association between MD-BED Gy3 and the risk of complication was assessed using serial multiple logistic regressions models. The associations between R-BED Gy3 and rectal complications and between V-BED Gy3 and bladder complications were assessed using multiple logistic regression models after adjustment for age, stage, tumor size and treatment duration. Serial Coxs proportional hazard regression models were used to estimate the relative risks of recurrence due to MD-BED Gy10 and the treatment duration. The overall complication rate for RTOG Grades 1 ? 4 toxicities was 33.1%. The 5-year actuarial pelvic control rate for all 743 patients was 83%. The midline cumulative BED dose, which is the sum of external midline BED and HDR-ICBT point A BED, ranged from 62.0 to 121.9 Gy10 (median 93.0) for tumors and from 93.6 to 187.3 Gy3 (median 137.6) for late responding tissues. The median cumulative values of actual rectal (R-BED Gy3) and bladder point BED (V-BED Gy3) were 118.7 Gy3 (range 48.8 ? 265.2) and 126.1 Gy3 (range: 54.9? 267.5), respectively. MD-BED Gy3 showed a good correlation with rectal (? =0.003), but not with bladder complications (? = 0.095), R-BED Gy3 had a very strong association (? = 3, B-BED Gy3 also showed significance in the prediction of bladder complications in a trend test (? = 0.0298). No statistically significant dose-response relationship for pelvic control was observed. The Sandwich and Continuous techniques, which differ according to when the ICR was inserted during the EBRT and due to the physicians preference, showed no differences in the local control and complication rates; there were also no differences in the 3 vs. 5 Gy fraction size of HDR-ICBT. The main reasons optimal dose-fractionation guidelines are not easily established is due to the absence of a dose-response relationship for tumor control as a result of the high-dose gradient of HDR-ICBT, individual differences in tumor responses to radiation therapy and the complexity of affecting factors. Therefore, in our opinion, there is a necessity for individualized tailored therapy, along with general guidelines, in the definitive radiation treatment for cervix cancer. This study also demonstrated the strong predictive value of actual rectal and bladder ref

2005-09-01

185

Uterine Fibroids  

Medline Plus

Full Text Available ... focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The procedure ... the bowel or bladder and those outside the image area cannot be treated with FUA. Summary Uterine ...

186

Prevalence of micronuclei in exfoliated uterine cervical cells from patients with risk factors for cervical cancer Prevalência de micronúcleos em células esfoliativas do colo uterino de pacientes com fatores de risco para o câncer de colo uterino  

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CONTEXT AND OBJECTIVE: Pap smears are the most common and inexpensive screening method for cervical cancer. We analyzed micronucleus prevalence in exfoliated cervical mucosa cells, to investigate associations between increased numbers of micronuclei and risk factors for cervical cancer. DESIGN AND SETTING: Analytical cross-sectional study, at Instituto de Pesquisa em Oncologia (IPON). METHODS: Exfoliated cervical cells were obtained from 101 patients between September 2004 and November 2005. ...

Lízia Maria Franco dos Reis Campos; Francisca da Luz Dias; Lusânia Maria Greggi Antunes; Eddie Fernando Candido Murta

2008-01-01

187

Uterine factors.  

Science.gov (United States)

Uterine anomalies are one of the most common parental causes of recurrent pregnancy loss, occurring in about 19% of patients. Congenital uterine anomalies are most likely caused by HOX gene mutations, although the mechanism is probably polygenic. There are no known environmental causes other than estrogenic endocrine disruptors such as diethylstilbestrol. Acquired uterine anomalies may result from uterine trauma (adhesions) or benign growths of the myometrium (fibroids) or endometrium (polyps). Although randomized controlled trials are lacking, surgical treatment is recommended for repair of uterine septa, and for removal of severe adhesions and submucosal fibroids, especially if no other causes are identified. PMID:24491984

Jaslow, Carolyn R

2014-03-01

188

Micronúcleos em células do colo uterino em mulheres HIV+ segundo sua condição de imunidade / Micronuclei in uterine cervical cells of women HIV+ according to immunocompetence markers  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: investigar a micronucleação (MN) em células esfoliadas do colo uterino de mulheres HIV+ observando as condições de imunidade aferidas pelos níveis de linfócitos CD4+ e da carga viral para o HIV (CV). MÉTODOS: foram obtidas coletas citológicas da junção escamocolunar de 23 pacientes HIV+ de [...] Ambulatório de DST/AIDS. O grupo controle foi composto por mulheres assintomáticas do Ambulatório de Prevenção de Câncer Ginecológico do mesmo serviço. O material foi submetido a processamento citológico para leitura em microscopia de luz, com objetiva de imersão em 2.000 células por paciente. Para avaliação da condição imunitária das pacientes HIV+ investigamos os níveis de linfócitos CD4+ e CV. A análise estatística dos resultados se fez com os testes do ?2 e Kolmogorov-Smirnov. RESULTADOS: vinte e três pacientes compuseram o grupo de mulheres HIV+ e 19 formaram o grupo controle. Em todas as pacientes HIV+ e em 84,2% do grupo controle detectamos MN. Dezessete pacientes HIV+ (73,9%) tiveram mais de 7 MN. No grupo controle tivemos apenas 1 caso (5,2%) com mais de 7 MN. Houve tendência na associação de maiores quantidades de MN em mulheres com baixos níveis de linfócitos CD4+ e maiores níveis de CV, sem caracterizar correlação estatística. CONCLUSÕES: pacientes HIV+ em fase de AIDS têm maior ocorrência de MN que o grupo controle e, também, a frequência com que são detectados MN parece estar associada a piores condições clínicas da imunossupressão. Abstract in english PURPOSE: to investigate the micronucleation (MN) of exfoliated cells from the uterine cervix of HIV+ women according to immunocompetence status. We investigated the clinical conditions of immunocompetence by analyzing the levels of CD4+ lymphocytes and viral count for HIV (VC). METHODS: biological m [...] aterial was collected from 23 HIV+ patients whose cervical oncologic cytology results were negative. They were patients from the STD/AIDS-FCMS-PUCSP who underwent a cytobrush collection in the squamous columnar junction. Similar material was obtained from 19 healthy control women. The material, about 2000 cells per patient, was processed for cytology using light microscopy and an immersion objective. To analyze the immunological status of HIV+ patients we used CD4+ count and VC. Statistical analysis was performed using the ?2 and Kolmorogov-Smirnov tests. RESULTS: twenty-three pacients composed the group of HIV+ women and 19 composed the control group. We found micronuclei (MN) in all HIV+ patients and in 84.2% of the control group. In 17 73.9% of the HIV+ patients and in 5.2% of the control group we found more than 7 MN cells. MN tended to occur more among women with poorer immunological status in the HIV+ group. CONCLUSIONS: HIV+ patients in the AIDS phase have a higher prevalence of micronucleated cells, as opposed to a control group. Also, the frequency of MN was associated with worse conditions of immunosuppression.

Camila Figueira, Mendes; Gildo, Gardinalli Filho; Renato Marinho, Furoni; Luís Vicente Vélez, Miranda; Júlio, Boschini Filho; Luiz Ferraz De, Sampaio Neto.

189

Evaluación del seguimiento de mujeres con cáncer cervicouterino en dos policlínicos. Pinar del Río Follow-up assessment of women suffering from cervical uterine cancer in two polyclinics, Pinar del Rio  

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Full Text Available Introducción: A pesar de contar con un programa de detección precoz del cáncer cervicouterino de larga duración aún no se logran los resultados esperados. Objetivo: Caracterizar a las pacientes con cáncer invasor del cuello uterino en dos áreas de salud de Pinar del Río en el quinquenio 2003-2007. Material y Método: Estudio observacional, transversal, de cohorte, retrospectivo de mujeres de cualquier edad con diagnóstico de cáncer cervicouterino invasor. La información de las pacientes se tomó de los registros automatizados de las lesiones de cuello uterino de la consulta provincial de Patología de Cuello, del Provincial de Cáncer (Dirección Provincial de Salud, y del de Mortalidad General (Dirección Provincial de Salud así como de las historias clínicas de la Unidad Oncológica Provincial. Entre las variables estudiadas estuvieron si procedían o no del programa, edad, estadio clínico, tratamiento recibido, incidencia anual y el promedio en la etapa, la mortalidad y la letalidad. Resultados: Se encontró que el 70,6% de casos no se detectó por programa. La tasa de incidencia promedio fue 29.5 por 100000 mujeres de 15 años y más. Todas las pacientes recibieron el tratamiento oncoespecífico según estadio clínico. Las mayores tasas de mortalidad se encontraron en las pacientes en estadio IIIB al diagnóstico. Conclusiones: Se detectan fallas en la Atención Primaria de Salud, por falta de detección. Las tasas de incidencia de esta enfermedad no se han logrado disminuir. Y se siguen diagnosticando casos en estadios avanzados de la enfermedad, lo que acorta la sobrevida de estas pacientes.Introduction: Despite of having a program, for a long time, to the early detection of cervical uterine cancer, the results expected are not as far achieved. Objective: to characterize the patients suffering from invasive cervical uterine cancer in two health areas in Pinar del Rio province throughout five years (2003-2007. Material and Methods: observational, cross-sectional, cohort, retrospective study including women at every age with invasive cervical-uterine cancer. The information concerning the patients was collected from the automated records of cervical uterine at the provincial office for cervix pathology treatment (Provincial Public Health Direction, general death rate (Provincial Public Health Direction and from the clinical histories of the Provincial Cancer Unit. Among the variables studied were: coming or not from the program, age, clinical stage, treatment followed, and annual incidence, together with the average of mortality and lethality considering the clinical stages. Results: 70,6% of the cases were not detected by the program. The average incidence rate was 29.5 per 10 0000 women from 15 years old or older. All patients underwent to a specific cancer treatment according to the clinical stage. The greatest mortality rates were found in patients presenting IIIB stage at diagnosis. Conclusion: errors were observed in Primary Health Care leading to deficiencies in the early detection of this type cancer. The incidence rates of this disease have not diminished; cases suffering from advanced stages of the disease are still detected, shortening the survival rate of these patients.

José Guillermo Sanabria Negrín

2012-06-01

190

Evaluación del seguimiento de mujeres con cáncer cervicouterino en dos policlínicos. Pinar del Río / Follow-up assessment of women suffering from cervical uterine cancer in two polyclinics, Pinar del Rio  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Introducción: A pesar de contar con un programa de detección precoz del cáncer cervicouterino de larga duración aún no se logran los resultados esperados. Objetivo: Caracterizar a las pacientes con cáncer invasor del cuello uterino en dos áreas de salud de Pinar del Río en el quinquenio 2003-2007. M [...] aterial y Método: Estudio observacional, transversal, de cohorte, retrospectivo de mujeres de cualquier edad con diagnóstico de cáncer cervicouterino invasor. La información de las pacientes se tomó de los registros automatizados de las lesiones de cuello uterino de la consulta provincial de Patología de Cuello, del Provincial de Cáncer (Dirección Provincial de Salud), y del de Mortalidad General (Dirección Provincial de Salud) así como de las historias clínicas de la Unidad Oncológica Provincial. Entre las variables estudiadas estuvieron si procedían o no del programa, edad, estadio clínico, tratamiento recibido, incidencia anual y el promedio en la etapa, la mortalidad y la letalidad. Resultados: Se encontró que el 70,6% de casos no se detectó por programa. La tasa de incidencia promedio fue 29.5 por 100000 mujeres de 15 años y más. Todas las pacientes recibieron el tratamiento oncoespecífico según estadio clínico. Las mayores tasas de mortalidad se encontraron en las pacientes en estadio IIIB al diagnóstico. Conclusiones: Se detectan fallas en la Atención Primaria de Salud, por falta de detección. Las tasas de incidencia de esta enfermedad no se han logrado disminuir. Y se siguen diagnosticando casos en estadios avanzados de la enfermedad, lo que acorta la sobrevida de estas pacientes. Abstract in english Introduction: Despite of having a program, for a long time, to the early detection of cervical uterine cancer, the results expected are not as far achieved. Objective: to characterize the patients suffering from invasive cervical uterine cancer in two health areas in Pinar del Rio province throughou [...] t five years (2003-2007). Material and Methods: observational, cross-sectional, cohort, retrospective study including women at every age with invasive cervical-uterine cancer. The information concerning the patients was collected from the automated records of cervical uterine at the provincial office for cervix pathology treatment (Provincial Public Health Direction), general death rate (Provincial Public Health Direction) and from the clinical histories of the Provincial Cancer Unit. Among the variables studied were: coming or not from the program, age, clinical stage, treatment followed, and annual incidence, together with the average of mortality and lethality considering the clinical stages. Results: 70,6% of the cases were not detected by the program. The average incidence rate was 29.5 per 10 0000 women from 15 years old or older. All patients underwent to a specific cancer treatment according to the clinical stage. The greatest mortality rates were found in patients presenting IIIB stage at diagnosis. Conclusion: errors were observed in Primary Health Care leading to deficiencies in the early detection of this type cancer. The incidence rates of this disease have not diminished; cases suffering from advanced stages of the disease are still detected, shortening the survival rate of these patients.

Sanabria Negrín, José Guillermo; Cruz Hernández, Inalvis de la Caridad; Oriolo Pérez, Leonardo; Pérez Herrera, Miguel Angel; Valdés Abreu, Beatriz.

191

Vaginal misoprostol for cervical priming before hysteroscopy  

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"nBackground: As an important diagnostic and therapeutic procedure for patients with intrauterine diseases, hysteroscopy permits a good view of the uterine cavity, thereby increasing diagnostic accuracy. Complications often encountered during hysteroscopy primarily concern problems with cervical dilatation and include uterine perforation, cervical tears, and the creation of false tracts. In this study, we investigate the utility of vaginal misoprostol for cervical dilatation in women und...

Valadan M; Rezaee Z; Mohammadpour J; Moghadami Tabrizi N

2008-01-01

192

[Uterine collagens. General review].  

Science.gov (United States)

Several collagen types (mainly types I, III, V and VI), elastin, fibronectin and some proteoglycans are active constituents of uterine myometer. They surround and associate smooth muscle cells. The type I collagen biosynthesis in the uterus is under the positive control of estrogens that in addition repress the collagenase secretion and in this way prevent collagen from degradation. The cervical softening and dilation are caused by a progressive degradation of collagen and by the synthesis of an additional proteoglycan that separates and disorganizes the collagen fibres. Prostaglandin E2 and relaxin participate in the activation of collagenases. After delivery, the drop in estrogens and progesterone permits collagenases to rapidly degrade uterine collagen in excess. PMID:1663655

Borel, J P

1991-12-01

193

[Evaluation of short-term exposure to a polyacrylonitrile cervical dilator in preabortion preparation of the uterine cervix in adolescent girls].  

Science.gov (United States)

Authors investigated possibilities of application of polyacryl-nitrile cervical dilators PCD-Dilapan in preabortion preparation of the cervix during the first trimester of pregnancy in 39 adolescent patients. Control of the achieved degree of cervical dilatation was performed by largest No Hegar dilator which did not show resistance during insertion. The control group comprised 35 adolescent patients in whom cervical dilatation was performed only by Hegar dilators till optimal dilatation for vacuum aspiration was achieved. Mean cervical dilatation in the investigated group was means = 8.85 mm (SD +/- 0.85) and in the control group means = 8.55 mm (SD +/- 0.78) with no statistically significant difference (T = 0.024, p greater than 0.05). "Analogous visual scale" was used for pain estimation during cervical dilatation. In the investigated group means = 2.01 (SD +/- 1.83) of pain degrees while means = 6.71 (SD +/- 1.89) in the control group. Side effects during cervical dilatation were noted in 15.38% of patients in the investigated group and in 51.41% of patients in the control group which difference was not statistically significant (chi 2 = 5.59, p greater than 0.05). PMID:1749281

Beri?, B; Durdevi?, S; Vukeli?, J; Tomcov, A; Vejnovi?, T

1991-01-01

194

Potentialities in integral care: uterine cervical cancer prevention according to the users of the family health strategy Potencialidades en la atención integral: prevención de cáncer de cuello uterino de acuerdo con las usuarias de la estrategia salud de la familia Potencialidades no atendimento integral: a prevenção do câncer do colo do útero na concepção de usuárias da estratégia saúde da família  

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This study aimed to analyze the integral care in the uterine cervical cancer prevention practices in the conception of users of the Family Health Strategy through an exploratory and descriptive research with a qualitative approach. A total of 14 users who performed the Pap smear in December 2002 in four Family Health Units affiliated to Higher Education institutions were selected for the study. Data were collected between April and June 2003. We found that the users analyze and assess the pra...

2007-01-01

195

Integrative review of the nursing interventions used for the early detection of cervical uterine cancer Revisión integradora de las intervenciones de enfermería utilizadas para detección precoz del cáncer cervicouterino Revisão integrativa das intervenções de enfermagem utilizadas para detecção precoce do câncer cérvico-uterino  

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In a national program to combat cervical uterine cancer (CUC) four basic elements should exist: primary prevention, early detection, diagnosis/treatment and palliative care. Of these, early detection is the most effective modality. One of the purposes of Evidence-Based Practice (EBP) is to encourage the use of research results with the assistance provided, reinforcing the importance of research for clinical practice. This study aimed to evaluate the evidence available in the literature regard...

2011-01-01

196

Evolution of uterine cervical cancer mortality from 1979 to 1998 in the State of Rio Grande do Sul, Brazil / A evolução da mortalidade por câncer de colo de útero entre 1979 e 1998 no Rio Grande do Sul, Brasil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese A mortalidade por câncer de colo de útero tem diminuído em países desenvolvidos. Entretanto, no Brasil, os dados apontam o câncer de colo de útero como uma das mais freqüentes causas de morte por neoplasia em mulheres, estando em quarto lugar no Rio Grande Sul. Este estudo do tipo série-temporal ana [...] lisa a mortalidade por câncer de colo de útero e a evolução deste fenômeno no Rio Grande do Sul, no período entre 1979 e 1998. Os dados foram extraídos do Sistema de Informação sobre Mortalidade. Coeficientes de mortalidade padronizados foram analisados por meio de regressão linear simples. Estimou-se o impacto da mortalidade por esta causa sobre a duração de vida esperada para esta população utilizando-se o cálculo dos Anos Potenciais de Vida Perdidos (APVP). Observou-se uma tendência linear positiva dos coeficientes de mortalidade padronizados com incremento anual de 0,17, e o coeficiente anual médio dos óbitos no período foi de 7,58/ 100 mil. Esta doença foi responsável por uma média de 21,9±1,33 APVP. Assim, apesar do câncer de colo de útero ser uma doença prevenível e curável, observa-se um aumento de mortalidade por esta causa, sugerindo falhas nos programas de rastreamento desta doença. Abstract in english A decrease in uterine cervical cancer (CC) mortality has been observed in developed countries. However, mortality data in Brazil suggest that CC is one of the most frequent causes of cancer death in women; it is the fourth cause of death from cancer in women in Rio Grande Sul State. A time-trend eco [...] logical study was performed to analyze CC mortality trends in Rio Grande do Sul from 1979 to 1998. Data were collected from the Mortality Information System, Brazilian Ministry of Health (DATASUS). Standardized mortality ratios were calculated and linear regression was used for time-trend analysis. The impact of cervical cancer death on life expectancy was also estimated for the study population using potential years of life lost (PYLL). Standardized mortality ratios during the study period revealed a positive linear trend of 0.17, and the mean annual mortality rate was 7.58/100,000. Cervical cancer accounted for 21.9 ± 1.33 PYLL during the period. In conclusion, although CC is a preventable and curable disease, an increase is observed in mortality from this cause in Rio Grande do Sul State, which may suggest failure in screening programs for cervical cancer.

Luciane, Kalakun; Mary Clarisse, Bozzetti.

197

Evolution of uterine cervical cancer mortality from 1979 to 1998 in the State of Rio Grande do Sul, Brazil / A evolução da mortalidade por câncer de colo de útero entre 1979 e 1998 no Rio Grande do Sul, Brasil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: English Abstract in portuguese A mortalidade por câncer de colo de útero tem diminuído em países desenvolvidos. Entretanto, no Brasil, os dados apontam o câncer de colo de útero como uma das mais freqüentes causas de morte por neoplasia em mulheres, estando em quarto lugar no Rio Grande Sul. Este estudo do tipo série-temporal ana [...] lisa a mortalidade por câncer de colo de útero e a evolução deste fenômeno no Rio Grande do Sul, no período entre 1979 e 1998. Os dados foram extraídos do Sistema de Informação sobre Mortalidade. Coeficientes de mortalidade padronizados foram analisados por meio de regressão linear simples. Estimou-se o impacto da mortalidade por esta causa sobre a duração de vida esperada para esta população utilizando-se o cálculo dos Anos Potenciais de Vida Perdidos (APVP). Observou-se uma tendência linear positiva dos coeficientes de mortalidade padronizados com incremento anual de 0,17, e o coeficiente anual médio dos óbitos no período foi de 7,58/ 100 mil. Esta doença foi responsável por uma média de 21,9±1,33 APVP. Assim, apesar do câncer de colo de útero ser uma doença prevenível e curável, observa-se um aumento de mortalidade por esta causa, sugerindo falhas nos programas de rastreamento desta doença. Abstract in english A decrease in uterine cervical cancer (CC) mortality has been observed in developed countries. However, mortality data in Brazil suggest that CC is one of the most frequent causes of cancer death in women; it is the fourth cause of death from cancer in women in Rio Grande Sul State. A time-trend eco [...] logical study was performed to analyze CC mortality trends in Rio Grande do Sul from 1979 to 1998. Data were collected from the Mortality Information System, Brazilian Ministry of Health (DATASUS). Standardized mortality ratios were calculated and linear regression was used for time-trend analysis. The impact of cervical cancer death on life expectancy was also estimated for the study population using potential years of life lost (PYLL). Standardized mortality ratios during the study period revealed a positive linear trend of 0.17, and the mean annual mortality rate was 7.58/100,000. Cervical cancer accounted for 21.9 ± 1.33 PYLL during the period. In conclusion, although CC is a preventable and curable disease, an increase is observed in mortality from this cause in Rio Grande do Sul State, which may suggest failure in screening programs for cervical cancer.

Luciane, Kalakun; Mary Clarisse, Bozzetti.

198

Evolution of uterine cervical cancer mortality from 1979 to 1998 in the State of Rio Grande do Sul, Brazil A evolução da mortalidade por câncer de colo de útero entre 1979 e 1998 no Rio Grande do Sul, Brasil  

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Full Text Available A decrease in uterine cervical cancer (CC mortality has been observed in developed countries. However, mortality data in Brazil suggest that CC is one of the most frequent causes of cancer death in women; it is the fourth cause of death from cancer in women in Rio Grande Sul State. A time-trend ecological study was performed to analyze CC mortality trends in Rio Grande do Sul from 1979 to 1998. Data were collected from the Mortality Information System, Brazilian Ministry of Health (DATASUS. Standardized mortality ratios were calculated and linear regression was used for time-trend analysis. The impact of cervical cancer death on life expectancy was also estimated for the study population using potential years of life lost (PYLL. Standardized mortality ratios during the study period revealed a positive linear trend of 0.17, and the mean annual mortality rate was 7.58/100,000. Cervical cancer accounted for 21.9 ± 1.33 PYLL during the period. In conclusion, although CC is a preventable and curable disease, an increase is observed in mortality from this cause in Rio Grande do Sul State, which may suggest failure in screening programs for cervical cancer.A mortalidade por câncer de colo de útero tem diminuído em países desenvolvidos. Entretanto, no Brasil, os dados apontam o câncer de colo de útero como uma das mais freqüentes causas de morte por neoplasia em mulheres, estando em quarto lugar no Rio Grande Sul. Este estudo do tipo série-temporal analisa a mortalidade por câncer de colo de útero e a evolução deste fenômeno no Rio Grande do Sul, no período entre 1979 e 1998. Os dados foram extraídos do Sistema de Informação sobre Mortalidade. Coeficientes de mortalidade padronizados foram analisados por meio de regressão linear simples. Estimou-se o impacto da mortalidade por esta causa sobre a duração de vida esperada para esta população utilizando-se o cálculo dos Anos Potenciais de Vida Perdidos (APVP. Observou-se uma tendência linear positiva dos coeficientes de mortalidade padronizados com incremento anual de 0,17, e o coeficiente anual médio dos óbitos no período foi de 7,58/ 100 mil. Esta doença foi responsável por uma média de 21,9±1,33 APVP. Assim, apesar do câncer de colo de útero ser uma doença prevenível e curável, observa-se um aumento de mortalidade por esta causa, sugerindo falhas nos programas de rastreamento desta doença.

Luciane Kalakun

2005-02-01

199

Uterine Fibroids  

Science.gov (United States)

... evidence indicating how natural processes of scarring and wound healing go awry. A preliminary NIH study tested ... is possible to shrink uterine fibroids by directing ultrasound waves at them, superheating the fibroids and destroying ...

200

Uterine Fibroids  

Medline Plus

Full Text Available ... fullness in the lower abdomen Other symptoms of uterine fibroids include: ... and migration of the egg, which can result in infertility. After surgical removal of the fibroid, fertility is ...

 
 
 
 
201

Uterine Fibroids  

Medline Plus

Full Text Available Uterine Fibroids Introduction Fibroids are common, benign tumors of the uterus. They can cause significant pain, as well as abnormal bleeding. About 30% of all women may have fibroids. Most ...

202

Uterine Fibroids  

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Full Text Available ... such as: • Excessive or painful bleeding during menstruation • Bleeding between periods • A feeling of fullness in the lower abdomen Other symptoms of uterine fibroids include: • Frequent urination ...

203

Uterine Fibroids  

Medline Plus

Full Text Available ... Uterine fibroid embolization (UFE) is a treatment that cuts off the blood supply to the uterus and the ... particles that are put into the fibroids to cut off their blood supply travel to the ovaries. In ...

204

Uterine Fibroids  

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Full Text Available ... uses focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The ... a device that combines two systems – a magnetic resonance imaging (MRI) machine to visualize patient anatomy, map ...

205

Uterine Fibroids  

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Full Text Available ... uterine fibroids and their causes, symptoms, diagnosis, and treatment options. Anatomy Vagina Uterus Fallopian Tubes Ovaries The female ... in shrinking the uterus and the fibroids. New treatment options have been developed to deal with fibroids. These ...

206

Uterine prolapse  

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... how to insert, clean, and remove a pessary. Side effects of pessaries include: Foul smelling discharge from the ... Other procedures are also available. Often, a vaginal hysterectomy is used to correct uterine prolapse. Any sagging ...

207

Uterine Fibroids  

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Full Text Available ... Ablation uses focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The ... uses a device that combines two systems – a magnetic resonance imaging (MRI) machine to visualize patient anatomy, map ...

208

Uterine Fibroids  

Medline Plus

Full Text Available ... well as abnormal bleeding. About 30% of all women may have fibroids. Most of them do not ... may be discovered during a routine examination. Some women who have uterine fibroids may experience symptoms such ...

209

Benefits of MRI in planning curie therapy of cervical cancers; Interets de l'IRM dans la planification de curietherapie des cancers du col uterin  

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As image-guided curie-therapy of cervical cancers is an always more used technique, the authors report a comparison of the contours of anatomo-clinic target volumes as they are defined by scanography and MRI. It appears that the first one overestimates the target volumes, while MRI improves the volume definition and allows treated volumes to be reduced. Short communication

Peignaux, K.; Petitfils, A.; Truc, G.; Martin, E.; Chamois, J.; Ligey-Bartolomeu, A.; Crehange, G.; Maingon, P. [Centre Georges Francois Leclerc, 21 - Dijon (France); Guiu, B.; Krause, D. [CHU du Bocage, 21 - Dijon (France)

2010-10-15

210

Magnetic resonance imaging of cancer of uterine cervix and body. Preliminary study in 9 cases of body cancer and 20 of cervical cancer  

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We studied nine cases of endometrial carcinoma and twenty of cervix carcinoma. Correlation with histology is made after curietherapy in 8 cases of endometrial carcinoma. Tumor is not always seen and particularly when there is no mass effect on macroscopic examination. Myometral invasion is not seen with accuracy: the interruption of junctional zone is not a good sign. The cervix tumors are well seen on T2 sequences before any treatment. There extra uterine extension is difficult to appreciate. The best results of RMI were in the follow-up after radiotherapy. Therefore it appears actually to us the best indication of RMI

1987-01-01

211

Increase in Viral Load, Viral Integration, and Gain of Telomerase Genes during Uterine Cervical Carcinogenesis can be Simultaneously Assessed by the HPV 16/18 MLPA-Assay  

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Oncogenic human papillomavirus (HPV) infection is the most important risk factor in cervical carcinogenesis cases; high viral loads, viral integration into the host genome, and gain of the telomerase-related genes, TERT and TERC, are all factors associated with progression to cancer. A recently developed multiparameter HPV 16/18 multiplex ligation-dependent probe amplification (MLPA) assay, which allows the simultaneous assessment of these factors, was applied to a series of 67 normal and (pr...

2010-01-01

212

A case report of anal cancer preceded by perianal Paget's disease after irradiation for uterine cervical cancer and review of perianal Paget's disease in Japan  

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The patient was a 59-year-old woman. Total hysterectomy and irradiation were performed for uterine cervical cancer 25 year previously. Paget's cells resembling signet ring cells were found in the epidermis, and anal cancer was present adjacent to them. The histological diagnosis of the anal cancer was mainly well differentiated adenocarcinoma, but mucinous carcinoma was present containing signet ring cells at sites contiguous with the anal glands, and lymphatic permeation was noted in the dermis. The cancer and the Paget's cells were both positive for PAS and alcian blue staining and were negative for PB/KOH/PAS staining. Furthermore, such findings as atypia of the glandular ducts and endoarteritis were detected in the underlying mucosa. Therefore, it was considered that this patient had anal cancer derived from the anal glands, that the Paget's cells were due to the intraepidermal extension of signet ring cells, and that the cancer may have been related to her previous irradiation. Reports of cancer of the rectum and anus complicated by Paget's lesion in Japan were reviewed and studied with regard to the histogenesis. It was concluded that peri-anal Paget's lesion had a close relationship with anal cancer derived from the anal glands. (author).

Kumegawa, Hiroshi; Shirouzu, Kazuo; Isomoto, Hiroharu; Araki, Yasuzo; Morodomi, Tachisumi; Nakagawa, Kiichiro; Kakegawa, Teruo (Kurume Univ., Fukuoka (Japan). School of Medicine)

1991-03-01

213

Can ABCF2 protein expression predict the prognosis of uterine cancer?  

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Uterine cervical and endometrial cancers are common malignant solid neoplasms for which there are no useful prognostic markers. In this study, we evaluate the relationship between ATP-binding cassette superfamily F2 (ABCF2) expression and clinical factors including clinical stage, histologic type, grade and prognosis in uterine cervical and endometrial cancer. Two hundred and sixty seven cervical and 103 endometrial cancers were studied. ATP-binding cassette superfamily F2 cytoplasmic express...

2008-01-01

214

Laparoscopia quirúrgica en cáncer de cuello uterino, en el Hospital IV Huancayo EsSalud / Surgical laparoscopy in uterine cervical cancer at EsSalud Huancayo Hospital  

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Full Text Available SciELO Peru | Language: Spanish Abstract in spanish Introducción: El cáncer de cérvix es la causa más frecuente de muerte en la sierra central peruana. El tratamiento quirúrgico (histerectomía total laparoscópica e histerectomía radical más linfadenectomía pélvica laparoscópica) es el recurso terapéutico mayormente curativo en los estadios iníciales [...] (Ia1, Ia2 y Ib1). Hace un año en el Servicio de Ginecología del Hospital IV Huancayo iniciamos el tratamiento quirúrgico laparoscópico en estos estadios. Objetivos: Revisar los resultados de histerectomía laparoscópica en cáncer microinvasivo de cuello uterino. Diseño: Estudio retrospectivo. Institución: Servicio de Ginecología, Hospital IV Huancayo, EsSalud, Junín, Perú. Pacientes: Doce mujeres sometidas a histerectomía laparoscópica por carcinoma microinvasivo de cérvix. Intervenciones: En seis mujeres con diagnóstico preoperatorio de cáncer de cérvix por conización cervical y estadio clínico Ia1 se les realizó histerectomía laparoscópica, con un tiempo operatorio de 59,16 minutos y tiempo de estancia hospitalaria de 4,1 días. A otras seis mujeres con estadio clínico Ia2-Ib1 se les realizó histerectomía radical más linfadenectomía pélvica laparoscópica, con un tiempo operatorio de 3 horas 58 minutos y tiempo de estancia hospitalaria de 10,1 días. Principales medidas de resultados: Curación clínica. Resultados: Todos los diagnósticos fueron confirmados con la pieza operatoria, y todas las pacientes están teóricamente curadas (márgenes libres, ganglios negativos); una paciente presentó complicaciones, requiriendo estancia prolongada (8,3%). Conclusiones: La histerectomía total laparoscópica y la histerectomía radical más linfadenectomía pélvica laparoscópica pueden ser realizadas de manera más rápida y radical con respecto a la histerectomía convencional por laparotomía. Ambas son intervenciones factibles y seguras, que pueden garantizar la curación en el carcinoma microinvasivo de cuello uterino. Abstract in english Introduction: Cervical cancer is the most common cause of death in Peruvian central highlands. Surgical treatment (hysterectomy and total laparoscopic radical hysterectomy plus pelvic lymphadenectomy) is the best therapeutic resource in the early cancer stage (IA1, IA2 and IB1). One year ago we star [...] ted laparoscopic surgical treatment in these stages at Hospital IV Huancayo Gynecology Department. Objectives: To review outcomes of laparoscopic hysterectomy for microinvasive cervical cancer. Design: Retrospective study. Setting: Gynecology Service, Hospital IV Huancayo, EsSalud, Junin, Peru. Patients: Twelve women subjected to laparoscopic hysterectomy for cervical microinvasive carcinoma. Interventions: Six women with preoperative diagnosis by cervical conization and clinical stage IA1 underwent laparoscopic hysterectomy with 59.16 minutes operative time and 4.1 days hospital stay. Other six women with clinical stage Ia2-Ib1 underwent laparoscopic radical hysterectomy plus pelvic lymphadenectomy with operative time 3 hours and 58 minutes, and hospital stay of 10.1 days. Main outcome measures: Clinical cancer cure. Results: All diagnoses were confirmed by the surgical specimen and all were theoretically cured (negative margins, negative lymph nodes); one patient had complications that required prolonged stay (8.3%). Conclusions: Total laparoscopic hysterectomy and laparoscopic radical hysterectomy plus pelvic lymphadenectomy can be performed faster and more radically compared with conventional laparotomy. Both are feasible and safe interventions that ensure cure in microinvasive cervical carcinoma.

Molina-Loza, Ernesto; Altez-Navarro, Carlos; Ortiz-Lorenzo, Gregorio.

215

Impact of curie-therapy timing in the treatment of cervical cancer; Impact du timing de la curietherapie dans le traitement du cancer du col uterin  

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Curie-therapy conventionally comes before surgery in the treatment of cervical cancer, either alone or after a concomitant chemotherapy. The authors report a study of the impact of a reverse sequence (surgery before curie-therapy) on the exeresis quality and on the evolution of operable tumours. Among women treated between 2004 and 2009, 40 have been identified who had surgery before curie-therapy. Ages, tumour stages, average doses, and treatment procedures are discussed. The notably high rate of vaginal sections could be reduced or avoided by using the conventional protocol (curie-therapy before surgery). Short communication

Kochbati, L.; Bouzid, N.; Saidi, I.; Nasr, C.; Messai, T.; Hentati, D.; Gargouri, W.; Besbes, M.; Maalej, M. [Service de radiotherapie, institut Salah-Azaiz, Tunis (Tunisia)

2011-10-15

216

Relationship between total iso-effect dose and number of fractions for the treatment of uterine cervical carcinoma by high dose-rate intracavitary irradiation. Chapter 18  

International Nuclear Information System (INIS)

Results are compared in Japan for patients with cervical carcinoma treated by either 1) manual afterloading with low intensity 60Co or 137Cs or 2) remote afterloading with high intensity 60Co sources (Ralstron). No significant difference between them was found for the 5-year survival rates. The relationship between the total tumour dose at point A and the results of high and low dose-rate intracavitary treatment of the patients classified by the number of fractions was also investigated. From this, the optimal dose ranges for each of the fractionation schemes of both high and low dose-rate intracavitary irradiation were determined. (U.K.)

1980-01-01

217

Efficacy of Cone Biopsy of the Uterine Cervix during Frozen Section for the Evaluation of Cervical High Grade Intraepithelial Neoplasia (CIN II-III  

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Full Text Available Introduction & Objectives: This study was performed to determine the role of frozen section examination (FSE of the cone specimen in the evaluation of the resection margin status and to rule out invasion in patients with high-grade cervical intraepithelial neoplasia.Materials & Methods: Twenty patients with high grade intraepithelial neoplasia undergoing conization biopsy and frozen section examination were cross- sectionally studied from March 2008 until September 2009.The results of permanent paraffin sections were compared using FSE.Results: In this cross-sectional study, 15 out of 20 cases (75% showed the same results in frozen and permanent sections of cone biopsy specimen. Two patients out of the remaining 5 ones had higher grade of CIN in frozen section, 2 had lower grade and one was considered the same because CIN1 in FSE was normal in permanent sections.although The Paired Sample t-test showed no significant difference between the two groups of frozen and permanent section results (P-value=0.716, CI=95%. Conclusion: Frozen section evaluation of cervical cone biopsy specimens in patients with CIN II-III is accurate, efficient, and cost-effective.

V. Titidej

2010-01-01

218

[Cytological screening of uterine cervical cancer by samples in liquid medium (CytoRich). Preliminary study of a series of 111 292 patients].  

Science.gov (United States)

We report on the preliminary results of a series of 111,292 patients who benefited from a liquid medium sample (CytoRich) for cervical cancer screening. The number of dubious or limited smears was reduced by 0.03% and 0.53% respectively. The junction zone was better explored, and metaplastic changes were observed in 35.71% of the cases. This method improved the identification of low-grade lesions by +56% (2751/111,292; 2.47%) and of high-grade lesions by +75% (860/111,292; 0.77%), with a reduction in the number of ASCUS/AGUS by -44% (2065/111,292; 1.85%). This preliminary study confirms the results already published. The results demonstrating cytohistological correlation should prove to be a decisive factor, enabling the testing of the sensitivity and specificity of this technique. It will then be possible to envisage a future 'new paradigm' for screening cervical cancer as the result of a liquid medium sample, computer-assisted screening and HPV viral identification by Hybrid capture II. PMID:10676042

Saurel, J; Rabreau, M; Landi, M; Bondu, C; Montoya, G; Morancé, C; Auber, M; Percheron, N; Santa-Maria, M; Bec, M; Berteau, M J; Muller, E; Gominet, C; Besserves, S; Thomas, E

1999-12-01

219

Uterine Fibroids  

Medline Plus

Full Text Available ... and who are not candidates for surgery, hormone therapy may be used. Hormone therapy medications reduce estrogen levels and seem to be ... an alternative to leiomyomectomy, hysterectomy, watchful waiting, hormone therapy, or uterine fibroid embolization. FUA uses a device ...

220

Camp based awareness and screening programme of cervical cancer in rural area of Bangladesh.  

Science.gov (United States)

This population based cross sectional study was carried out in Muktagacha Upazilla Health Complex, Mymensingh, Bangladesh during the period of 26th to 28th June, 2012. The objective was to create awareness, to find out the precancerous lesion of cervix and to evaluate the effectiveness of this approach for prevention of cervical carcinoma. Women who were married and between 30-60 years and also women of below 30 years (who were married below the age of 18) were included in this study. All pregnant women were excluded from this study. After counseling, pelvic examination and VIA (visual inspection of cervix with application of 5% acetic acid) test was done. If the squamo-columner junction of cervix turned to white then it was called VIA positive (+ve) cases. Then they were referred to colposcopy clinic of Mymensingh Medical College with a red card for evaluation and management. During the 3 days campaign, 395 cases were examined. Among them, majority (49%) of the women were below the age of 30. It was observed that still 48.2% were married below the age of 18 and 31% had first pregnancy at an age or below 18 years. But number of grand multiparity is lowering now a days. Only 25% had para ?4. Others have para 1-3. During pelvic examination, the common cervico-uterine pathologies like chronic cervicities (16.5%), cervical erosion (14.4%), uterine prolapse (2.3%), cervical polyp (1%), myomatous polyp (0.3%) and advanced cervical carcinoma (0.5%) were also diagnosed clinically. Among the participants, 11.9% was detected as VIA+ve cases. A significant association of VIA+ve cases with low socio-economic conditions, hindu religion, early age at marriage and high parity were observed in this study (p<0.05). The findings of this study highlight the utility and need of camp based cervical cancer screening service at regular interval in the community. PMID:24292289

Shahida, S M; Saha, K; Banu, K A; Islam, M A

2013-10-01

 
 
 
 
221

Radiation therapy of the uterine cancer  

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Cervical and endometrial cancer of the uterus, and ovarian cancer are three major malignant diseases in gynecology in Japan. These diagnosis and therapy are almost established. In uterine cervical cancer, radiation therapy and surgery of these diseases are two main treatment methods, and both treatment results are almost the same. And radiation therapy is also used as postoperative treatment to patients with high risk factors. In endometrial cancer, surgery is main therapy. Radiation therapy is undergone only to medically inoperable cases preoperative radiation is widely carried out in Europe and America, but almost none in Japan. Postoperative irradiation is adapted to the cases with high risk factors. But recent advance of chemotherapy changes the importance of radiation therapy in such patients. I review the literatures of radiation therapy of uterine cervical cancer and of endometrial cancer. (author)

Noguchi, Hiroshi [Matsumoto National Hospital, Nagano (Japan)

1999-02-01

222

Insufficiency Fractures After Pelvic Radiation Therapy for Uterine Cervical Cancer: An Analysis of Subjects in a Prospective Multi-institutional Trial, and Cooperative Study of the Japan Radiation Oncology Group (JAROG) and Japanese Radiation Oncology Study Group (JROSG)  

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Purpose: To investigate pelvic insufficiency fractures (IF) after definitive pelvic radiation therapy for early-stage uterine cervical cancer, by analyzing subjects of a prospective, multi-institutional study. Materials and Methods: Between September 2004 and July 2007, 59 eligible patients were analyzed. The median age was 73 years (range, 37-84 years). The International Federation of Gynecologic Oncology and Obstetrics stages were Ib1 in 35, IIa in 12, and IIb in 12 patients. Patients were treated with the constant method, which consisted of whole-pelvic external-beam radiation therapy of 50 Gy/25 fractions and high-dose-rate intracavitary brachytherapy of 24 Gy/4 fractions without chemotherapy. After radiation therapy the patients were evaluated by both pelvic CT and pelvic MRI at 3, 6, 12, 18, and 24 months. Diagnosis of IF was made when the patients had both CT and MRI findings, neither recurrent tumor lesions nor traumatic histories. The CT findings of IF were defined as fracture lines or sclerotic linear changes in the bones, and MRI findings of IF were defined as signal intensity changes in the bones, both on T1- and T2-weighted images. Results: The median follow-up was 24 months. The 2-year pelvic IF cumulative occurrence rate was 36.9% (21 patients). Using Common Terminology Criteria for Adverse Events version 3.0, grade 1, 2, and 3 IF were seen in 12 (21%), 6 (10%), and 3 patients (5%), respectively. Sixteen patients had multiple fractures, so IF were identified at 44 sites. The pelvic IF were frequently seen at the sacroileal joints (32 sites, 72%). Nine patients complained of pain. All patients' pains were palliated by rest or non-narcotic analgesic drugs. Higher age (>70 years) and low body weight (<50 kg) were thought to be risk factors for pelvic IF (P=.007 and P=.013, Cox hazard test). Conclusions: Cervical cancer patients with higher age and low body weight may be at some risk for the development of pelvic IF after pelvic radiation therapy.

Tokumaru, Sunao, E-mail: tokumaru@cc.saga-u.ac.jp [Department of Heavy Particle Therapy and Radiation Oncology, Saga University, Saga (Japan); Toita, Takafumi [Department of Radiology, Graduate School of Medical Science, University of the Ryukyus, Okinawa (Japan); Oguchi, Masahiko [Radiation Oncology Department, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Maebashi (Japan); Kato, Shingo [Department of Radiation Oncology, Saitama Medical University, International Medical Center, Saitama (Japan); Niibe, Yuzuru [Department of Radiology, School of Medicine, Kitasato University, Sagamihara (Japan); Kazumoto, Tomoko [Department of Radiology, Saitama Cancer Center, Saitama (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan); Kataoka, Masaaki [Department of Radiology, National Shikoku Cancer Center, Matsuyama (Japan); Shikama, Naoto [Department of Radiation Oncology, Saitama Medical University, International Medical Center, Saitama (Japan); Kenjo, Masahiro [Department of Radiation Oncology, Graduate School of Medical Science, Hiroshima University, Hiroshima (Japan); Yamauchi, Chikako [Department of Radiation Oncology, Shiga Medical Center for Adults, Moriyama (Japan); Suzuki, Osamu [Department of Radiation Oncology, Osaka Medical Center for Cancer, Osaka (Japan); Sakurai, Hideyuki [Proton Medical Research Center and Tsukuba University, Tuskuba (Japan); Teshima, Teruki [Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita (Japan); Kagami, Yoshikazu [Department of Radiology, Showa University School of Medicine, Tokyo (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University, Graduate School of Medicine, Maebashi (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Graduate School of Medicine, Kyoto (Japan); and others

2012-10-01

223

Prospective Multi-Institutional Study of Definitive Radiotherapy With High-Dose-Rate Intracavitary Brachytherapy in Patients With Nonbulky (<4-cm) Stage I and II Uterine Cervical Cancer (JAROG0401/JROSG04-2)  

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Purpose: To determine the efficacy of a definitive radiotherapy protocol using high-dose-rate intracavitary brachytherapy (HDR-ICBT) with a low cumulative dose schedule in nonbulky early-stage cervical cancer patients, we conducted a prospective multi-institutional study. Methods and Materials: Eligible patients had squamous cell carcinoma of the intact uterine cervix, Federation of Gynecologic Oncology and Obstetrics (FIGO) stages Ib1, IIa, and IIb, tumor size <40 mm in diameter (assessed by T2-weighted magnetic resonance imaging), and no pelvic/para-aortic lymphadenopathy. The treatment protocol consisted of whole-pelvis external beam radiotherapy (EBRT) of 20 Gy/10 fractions, pelvic EBRT with midline block of 30 Gy/15 fractions, and HDR-ICBT of 24 Gy/4 fractions (at point A). The cumulative biologically effective dose (BED) was 62 Gy{sub 10} ({alpha}/{beta} = 10) at point A. The primary endpoint was the 2-year pelvic disease progression-free (PDPF) rate. All patients received a radiotherapy quality assurance review. Results: Between September 2004 and July 2007, 60 eligible patients were enrolled. Thirty-six patients were assessed with FIGO stage Ib1; 12 patients with stage IIa; and 12 patients with stage IIb. Median tumor diameter was 28 mm (range, 6-39 mm). Median overall treatment time was 43 days. Median follow-up was 49 months (range, 7-72 months). Seven patients developed recurrences: 3 patients had pelvic recurrences (2 central, 1 nodal), and 4 patients had distant metastases. The 2-year PDPF was 96% (95% confidence interval [CI], 92%-100%). The 2-year disease-free and overall survival rates were 90% (95% CI, 82%-98%) and 95% (95% CI, 89%-100%), respectively. The 2-year late complication rates (according to Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer of Grade {>=}1) were 18% (95% CI, 8%-28%) for large intestine/rectum, 4% (95% CI, 0%-8%) for small intestine, and 0% for bladder. No Grade {>=}3 cases were observed for genitourinary/gastrointestinal late complications. Conclusions: These results suggest that definitive radiotherapy using HDR-ICBT with a low cumulative dose schedule (BED, 62 Gy{sub 10} at point A) can provide excellent local control without severe toxicity in nonbulky (<4-cm) early-stage cervical cancer.

Toita, Takafumi, E-mail: b983255@med.u-ryukyu.ac.jp [Department of Radiology, Graduate School of Medical Science, University of Ryukyus, Okinawa (Japan); Kato, Shingo [Research Center for Charged Particle Therapy, National Institute of Radiological Sciences, Chiba (Japan); Niibe, Yuzuru [Department of Radiology, School of Medicine, Kitasato University, Sagamihara (Japan); Ohno, Tatsuya [Gunma University Heavy Ion Medical Center, Maebashi (Japan); Kazumoto, Tomoko [Department of Radiology, Saitama Cancer Center, Saitama (Japan); Kodaira, Takeshi [Department of Radiation Oncology, Aichi Cancer Center, Nagoya (Japan); Kataoka, Masaaki [Department of Radiology, National Shikoku Cancer Center, Ehime (Japan); Shikama, Naoto [Department of Radiation Oncology, Saku Central Hospital, Saku (Japan); Kenjo, Masahiro [Department of Radiation Oncology, Graduate School of Medical Science, Hiroshima University, Hiroshima (Japan); Tokumaru, Sunao [Department of Radiology, Saga University, Saga (Japan); Yamauchi, Chikako [Department of Radiation Oncology, Shiga Medical Center for Adults, Moriyama (Japan); Suzuki, Osamu [Department of Radiation Oncology, Osaka Medical Center for Cancer, Osaka (Japan); Sakurai, Hideyuki [Proton Medical Research Center and Tsukuba University, Tsukuba (Japan); Numasaki, Hodaka; Teshima, Teruki [Department of Medical Physics and Engineering, Graduate School of Medicine, Osaka University, Suita, Osaka (Japan); Oguchi, Masahiko [Department of Radiation Oncology, Cancer Institute Hospital, Tokyo (Japan); Kagami, Yoshikazu [Radiation Oncology Division, National Cancer Center Hospital, Tokyo (Japan); Nakano, Takashi [Department of Radiation Oncology, Gunma University, Graduate School of Medicine, Maebashi (Japan); Hiraoka, Masahiro [Department of Radiation Oncology and Image-applied Therapy, Kyoto University, Graduate School of Medicine, Kyoto (Japan); Mitsuhashi, Norio [Department of Radiation Oncology, Tokyo Women' s Medical University, Tokyo (Japan)

2012-01-01

224

Insufficiency Fractures After Pelvic Radiation Therapy for Uterine Cervical Cancer: An Analysis of Subjects in a Prospective Multi-institutional Trial, and Cooperative Study of the Japan Radiation Oncology Group (JAROG) and Japanese Radiation Oncology Study Group (JROSG)  

International Nuclear Information System (INIS)

Purpose: To investigate pelvic insufficiency fractures (IF) after definitive pelvic radiation therapy for early-stage uterine cervical cancer, by analyzing subjects of a prospective, multi-institutional study. Materials and Methods: Between September 2004 and July 2007, 59 eligible patients were analyzed. The median age was 73 years (range, 37-84 years). The International Federation of Gynecologic Oncology and Obstetrics stages were Ib1 in 35, IIa in 12, and IIb in 12 patients. Patients were treated with the constant method, which consisted of whole-pelvic external-beam radiation therapy of 50 Gy/25 fractions and high-dose-rate intracavitary brachytherapy of 24 Gy/4 fractions without chemotherapy. After radiation therapy the patients were evaluated by both pelvic CT and pelvic MRI at 3, 6, 12, 18, and 24 months. Diagnosis of IF was made when the patients had both CT and MRI findings, neither recurrent tumor lesions nor traumatic histories. The CT findings of IF were defined as fracture lines or sclerotic linear changes in the bones, and MRI findings of IF were defined as signal intensity changes in the bones, both on T1- and T2-weighted images. Results: The median follow-up was 24 months. The 2-year pelvic IF cumulative occurrence rate was 36.9% (21 patients). Using Common Terminology Criteria for Adverse Events version 3.0, grade 1, 2, and 3 IF were seen in 12 (21%), 6 (10%), and 3 patients (5%), respectively. Sixteen patients had multiple fractures, so IF were identified at 44 sites. The pelvic IF were frequently seen at the sacroileal joints (32 sites, 72%). Nine patients complained of pain. All patients' pains were palliated by rest or non-narcotic analgesic drugs. Higher age (>70 years) and low body weight (<50 kg) were thought to be risk factors for pelvic IF (P=.007 and P=.013, Cox hazard test). Conclusions: Cervical cancer patients with higher age and low body weight may be at some risk for the development of pelvic IF after pelvic radiation therapy.

2012-10-01

225

Percepção da vulnerabilidade entre mulheres com diagnóstico avançado do câncer do colo do útero / Perceiving vulnerability among women with advanced diagnosis of uterine cervical cancer / La percepción de la vulnerabilidad entre mujeres con diagnóstico de cáncer cervical avanzado  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Estudo descritivo, de abordagem qualitativa, que objetivou compreender a percepção da vulnerabilidade à doença, entre mulheres com diagnóstico avançado do câncer do colo do útero, tendo como referencial, a vulnerabilidade. Participaram doze mulheres que estavam em atendimento ambulatorial hospitalar [...] , para tratamento do câncer cérvico-uterino avançado. Os dados foram coletados por entrevistas e analisados por Análise de Conteúdo. Dos resultados emergiram duas categorias temáticas: Percebendo-se vulnerável na descoberta da doença e Percebendo-se vulnerável na realização do tratamento. Fatores relacionados à cliente, profissionais, serviços, entre outros, tornaram a mulher suscetível aos problemas e danos de saúde, relativos ao câncer cérvico-uterino, exacerbando sua vulnerabilidade à doença. É necessário superar deficiências no modelo de assistência e humanização do atendimento, no grau de compromisso e qualidade das instituições, dos recursos, gerenciamento e monitoramento dos programas de prevenção e detecção do câncer do colo do útero, nos diferentes níveis de atenção. Abstract in spanish Este estudio descriptivo y cualitativo tuvo como objetivo comprender la percepción de la vulnerabilidad a la enfermedad, entre las mujeres diagnosticadas con cáncer cervical avanzado, tomando como referencia la vulnerabilidad. Participaron doce mujeres que recibían atención ambulatoria hospitalaria [...] para el tratamiento del cáncer cervico uterino avanzado. La recolección de los datos se hizo a través de entrevistas y se analizaron mediante el análisis de contenido. Los resultados destacan dos temas: Percepción de su vulnerabilidad al descubrir la enfermedad, y percepción de su vulnerabilidad al realizar el tratamiento. Factores relacionados con el cliente, los servicios, los profesionales, entre otros, han hecho que las mujeres sean susceptibles a los problemas de salud y daños relacionados con el cáncer cervico uterino, lo que agrava su vulnerabilidad a las enfermedades. Es necesario superar las deficiencias en el modelo de tratamiento para el cuidado y la integridad personal, el grado de compromiso y calidad de las instituciones, recursos, programas de gestión y control para prevenir y detectar el cáncer del cuello uterino, en los diferentes niveles de atención. Abstract in english This descriptive qualitative study aimed to comprehend perceptions of vulnerability to disease among women diagnosed with advanced cervical cancer. Twelve women who were receiving outpatient hospital care in treating advanced cervical cancer participated in the study. Data was collected through inte [...] rviews and analyzed via content analysis. The results highlight two themes: Perceiving oneself as vulnerable in discovering the disease; and Perceiving oneself vulnerable in carrying out treatment. Factors related to the client, health care professionals, and services rendered, among others have made women susceptible to health problems and damage relating to cervical cancer, exacerbating their vulnerability to the disease. It is necessary to overcome deficiencies in care model and the humanization of treatment, the degree of commitment, as well as the quality of institutions, resources, management and monitoring programs towards preventing and detecting cervical cancer within different levels of care.

Angela Vieira, Pimentel; Marislei Sanches, Panobianco; Ana Maria de, Almeida; Iácara Santos Barbosa, Oliveira.

226

Sterility of the uterine cavity.  

DEFF Research Database (Denmark)

In a prospective open study the sterility of the uterine cavity was evaluated in 99 women admitted for hysterectomy. The indications for hysterectomy were in most cases persistent irregular vaginal bleeding and fibromyomas of the uterus. Samples for both aerobic and anaerobic bacteria, Chlamydia trachomatis, yeasts and viruses were taken preoperatively from the apex of the vagina and cervical os. Immediately after hysterectomy the uterus was opened under sterile conditions and samples obtained from the isthmus and fundus of the uterine cavity for microbiological examination. Wet smears were taken from the same sites. Nearly a quarter of all the patients harbored one or more microorganisms in the uterus, mostly Gardnerella vaginalis, Enterobacter and Streptococcus agalactiae. We found that in a significant number of cases, the uterine cavity is colonized with potentially pathogenic organisms which may play a causative role in endometritis. The results indicate that inflammation of the uterine cavity should be evaluated by hysteroscopic examination before hysterectomy is undertaken in patients with persistent irregular vaginal bleeding. Udgivelsesdato: 1995-Mar

Møller, B R; Kristiansen, F V

1995-01-01

227

Computed Tomography-Based High-Dose-Rate Intracavitary Brachytherapy for Uterine Cervical Cancer: Preliminary Demonstration of Correlation Between Dose-Volume Parameters and Rectal Mucosal Changes Observed by Flexible Sigmoidoscopy  

International Nuclear Information System (INIS)

Purpose: To compare the dose-volume histogram (DVH) parameters obtained by three-dimensional gynecologic brachytherapy planning with the rectosigmoid mucosal changes observed by flexible sigmoidoscopy. Methods and Materials: Between January 2004 and July 2005, 71 patients with International Federation of Gynecology and Obstetrics Stage IB-IIIB uterine cervical cancer underwent computed tomography-based high-dose-rate intracavitary brachytherapy. The total dose (external beam radiotherapy [RT] plus intracavitary brachytherapy) to the International Commission of Radiation Units and Measurements rectal point (ICRURP) and DVH parameters for rectosigmoid colon were calculated using the equivalent dose in 2-Gy fractions (?/? = 3 Gy). Sigmoidoscopy was performed every 6 months after RT, with the 6-scale scoring system used to determine mucosal changes. Results: The mean values of the DVH parameters and ICRURP were significantly greater in patients with a score of ?2 than in those with a score RP, 71 Gy?/?3 vs. 66 Gy?/?3, p = 0.02; D0.1cc, 93 Gy?/?3 vs. 85 Gy?/?3, p = 0.04; D1cc, 80 Gy?/?3 vs. 73 Gy?/?3, p = 0.02; D2cc, 75 Gy?/?3 vs. 69 Gy?/?3, p = 0.02). The probability of a score of ?2 showed a significant relationship with the DVH parameters and ICRURP (ICRURP, p = 0.03; D0.1cc, p = 0.05; D1cc, p = 0.02; D2cc, p = 0.02). Conclusion: Our preliminary data have shown that DVH values of the rectosigmoid colon obtained by computed tomography-based three-dimensional brachytherapy planning are reliable and predictive of score ?2 rectosigmoid mucosal changes

2007-08-01

228

Antimicrobial factors in the cervical mucus plug  

DEFF Research Database (Denmark)

The cervical mucus plug is positioned between the microbe-rich vagina and the normally sterile uterine cavity, which suggests a host defense function, but few relevant data are available. We analyzed the composition and antimicrobial activity of cervical mucus plugs.

Hein, Merete; Valore, Erika V

2002-01-01

229

Combined radiation and chemotherapy for locally advanced cervical cancer: preliminary study; Radio-chimiotherapie concomitante dans les cancers du col uterin localement avances: etude preliminaire  

Energy Technology Data Exchange (ETDEWEB)

We have designed a combined treatment strategy of bifractionated split course radiotherapy (RT) and concomitant chemotherapy (CT) to try to improve the results of RT in inoperable cervical carcinoma. After evaluation, patients were submitted to further radical surgery or additional RT-CT depending on the treatment results. Between January 1992, 25 patients with non metastatic inoperable disease entered in the protocol. The stage of the disease was: T{sub 3}N{sub 0}4 patients, T{sub 3} with hydronephrosis seven patients, T{sub 3}N{sub 1} 12 patients, and T{sub 4}N{sub 0} two patients. Nineteen patients received two courses of CT with fluorouracil (F), cisplatin (P) with or without etoposide. Pelvic RT was given twice daily (two fractions of 3 Gy) on days 1, 3, 15 and 17. A combination of F 400 mg/m{sup 2}/d and P 15 mg/m{sup 2}/d in continuous infusion with oral etoposide (100 mg/d) and hydroxyurea (500 mg/d) in 11 patients was delivered concomitantly on days 1-3 and 14-17. A clinical and radiological evaluation was performed four weeks later. Patients with objective response underwent radical hysterectomy (group A) and those with incomplete response received additional RT-CT protocol (group B). All patients had endocavitary brachytherapy at the end of treatment. After two cycles of CT there were four PR in 19 patients and 5 failures. (authors). 36 refs., 1 fig.

Delanian, S.; Housset, M.; Maulard-Durdux, C. [Hopital Saint-Louis, 75 - Paris (France); Taurelle, R.; Lecuru, F. [Hopital boucicaut, 75 - Paris (France); Baillet, F. [Hopital Pitie-Salpetriere, 75 - Paris (France)

1995-12-31

230

[Role of oxytocin in activation of spontaneous electrical activity of uterine body and uterine tubes in non-pregnant rats].  

Science.gov (United States)

The work studies effects of various doses of oxytocin (0.01, 0.1, 1 and 10 microg/kg) on duration of discharges of spontaneous electrical activity and frequency of spikes in various parts of uterine tubes and of uterine body of non-pregnant rats. Under these conditions, changes in these parameters for ovarian parts of the uterine tubes had similar character unlike those in cervical parts of the tubes and in the middle part of the uterine body, so the latter parts can be grouped together owing to peculiarities of their changes. The longest duration of genesis of electric discharges has been shown for the ovarian part of uterine tubes at a concentration of 10 microg/kg of oxytocin. Morphological experiments revealed that among all studies areas the ovarian parts of uterine tubes were characterized by the highest amount of atypical cells that have the maximally pronounced functional activity. PMID:21780644

Kazarian, K V; Unanian, N G; Meliksetian, I B; Akopian, R R; Saakian, A A

2011-01-01

231

Intracavitary combined with CT-guided interstitial brachytherapy for locally advanced uterine cervical cancer. Introduction of the technique and a case presentation  

International Nuclear Information System (INIS)

We report a new technique of brachytherapy consisting of intracavitary combined with computed tomography (CT)-guided interstitial brachytherapy for locally advanced cervical cancer. A Fletcher-Suit applicator and trocar point needles were used for performing high-dose rate brachytherapy under in-room CT guidance. First, a tandem and ovoids were implanted into the patient's vagina and uterus by conventional brachytherapy method. Based on clinical examination and MRI/CT imaging, operating radiation oncologists decided the positions of insertion in the tumor and the depth of the needles from the upper surface of the ovoid. Insertion of the needle applicator was performed from the vaginal vault inside the ovoid within the tumor under CT guidance. In treatment planning, dwell positions and time adaptations within the tandem and ovoids were performed first for optimization based on the Manchester system, and then stepwise addition of dwell positions within the needle was continued. Finally, dwell positions and dwell weights were manually modified until dose-volume constraints were optimally matched. In our pilot case, the dose of D90 to high-risk clinical target volume was improved from 3.5 Gy to 6.1 Gy by using our hybrid method on the dose-volume histogram. D1cc of the rectum, bladder and sigmoid colon by our hybrid method was 4.8 Gy, 6.4 Gy and 3.5 Gy, respectively. This method consists of advanced image-guided brachytherapy that can be performed safely and accurately. This approach has the potential of increasing target coverage, treated volume, and total dose without increasing the dose to organs at risk. (author)

2011-01-01

232

Selective uterine arterial embolization of uterine myoma  

International Nuclear Information System (INIS)

Objective: Study the value of clinical application of Baiji and absorbable Gelatin in embolizing uterine myoma together with its effect, side effect and complication. Methods: 21 women with uterine myoma undergoing selective uterine arterial embolization by Seldinger's technique were studied. After retrograde trans-femoral introduction of a 5 french catheter, the uterine arteries were successively catheterized. Baiji and absorbable Gelatin sponge particles were injected through free flow until devasculariztion. Results: Uterine myomas blood supply came from bilateral uterine arteries demonstrated by angiography. All the supplying artery images disappeared after the embolization. 3-6 months follow-up study showed: a marked reduction in the size of myomata by 38%-90%. Clinical symptoms were improved. There was one failure cas and then underwent uterotomy due to infection. Conclusions: The short-term effect of using Baiji and absorbable Gelatin for embolizing uterine myoma is clinically significant, while long-term effects is still waiting for research

2001-12-01

233

Uterine Fibroid Embolization  

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Uterine fibroids are commonly asymptomatic. They often cause pelvic pain, abnormal and increased vaginal bleeding, etc. Traditional treatment of symptomatic uterine fibroids was trans-abdominal hysterectomy. Nowadays, uterine artery embolization (UAE), also called uterine fibroid embolization, is considered as a safe and highly-effective nonsurgical treatment for women with symptomatic uterine fibroid tumors. Advantages of UAE over conventional hormonal suppression and surgical procedures inc...

Malek, R.; Padidar, A.

2003-01-01

234

Análise de um programa municipal de prevenção do câncer cérvico-uterino Análisis de un programa municipal de prevención del cáncer del cuello uterino Analysis of a municipal program of uterine cervical neoplasm prevention  

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Full Text Available Trata-se de um estudo descritivo-exploratório com objetivo de analisar o programa de prevenção do câncer cérvico uterino no município de Igarapava/SP. No ano de 2006, a rede pública municipal realizou uma cobertura de 14,9% da população feminina na faixa etária de 25 a 59 anos, metade da razão mínima esperada para os municípios, sendo a faixa etária predominante das coletas de 20 a 34 anos (43,2%. Um total de 6,3% não compareceu no serviço de saúde a fim de receber o resultado. Quanto aos resultados das coletas, 51.6% (774 estavam dentro dos limites de normalidade e 47,9% (719 apresentaram alguma alteração, sendo 0,1% compatível com NIC II e III.Se trata de un estudio descriptivo-exploratorio con el objetivo de análisar el programa de prevención del cáncer del cuello uterino en el distrito municipal de Igarapava/SP. En el año de 2006, la red pública municipal realizó una cobertura de 14,9% de la población femenina en la faja de edad de 25 a 59 años, la mitad de la razón mínima esperada para los distritos municipales, siendo la faja de edad predominante de las colecciones de 20 a 34 años (43,2%. Un total de 6,3% no asistió en el servicio de salud para recibir el resultado. En cuanto a los resultados de las colecciones, 51,6% (774 de ellos estaban dentro de los límites de normalidad y 47,9% (719 de ellos presentaron alguna alteración, mientras siendo 0,1% compatible con NIC II e III.This is a descriptive-exploratory study that aimed at analysing the program of uterine cervical neoplasm prevention in the city of Igarapava/SP. In the year of 2006, the municipal public service realized a preventive program with 14.9% of the feminine population from 25 to 59 years old, half of the minimum expected for the cities, whereas the predominant age of those colleted were of 20 to 34 years old (43.2%. A total of 6.3% did not show up at the public health centers in order to get the results. Regarding the results of the collecting, 51.6% (774 were within the limits of normality and 47.9% (719 presented some alteration, where 0.1% were compatible with CIN I and II.

Maurícia Brochado Oliveira Soares

2010-04-01

235

Uterine sarcoma.  

Science.gov (United States)

Thirty-four cases of uterine sarcoma were studied with regard to their pathologic characteristics and response to treatment. Pathologic features did not always correlate with subsequent course. Combined therapy seems to enhance two-year survival in endometrial stromal sarcoma (ESS), although some patients may have low-grade tumors and hence represent a more favorable group. Adjuvant irradiation may improve local control rates in some mixed mesodermal sarcomas (MMS), but does not add appreciably to survival. It is of doubtful benefit in the leiomyosarcoma (LMS) group. When irradiation is employed, preoperative therapy is preferred except in the highly malignant mixed mesodermal sarcomas where prompt surgery seems indicated first. Supplemental brachytherapy may also be employed. PMID:1208858

Belgrad, R; Elbadawi, N; Rubin, P

1975-01-01

236

[Uterine fibroids].  

Science.gov (United States)

The uterine fibroid is a benign tumour. The prevalence, in all the population, is 50% for european women and 80% for black women. 30% of fibroids are symptomatic. The new FIGO classification gives 7 positions (0 to 7), submuccus (0, 1, 2), interstitial (3, 4, 5), subserous (6, 7). Diagnosis is performed by 2D and 3D ultrasound which could be associated by hysterosonography. Hysteroscopy and MRI could be proposed. Hysterectomy is the main treatment, if possible by vaginal or laparoscopic way. Conservative treatment (myomectomy) could be realized by hysteroscopic, laparoscopic way or laparotomy for patients who desire to preserve fertility. Arteries embolisation is an alternative to hysterectomy or myomectomy for patients without desire of pregnancy. Preoperative treatments by GnRH agonist or SPRM like ulipristal acetate treat anaemia, decrease the myoma volume and could modify the therapeutic strategy. PMID:24855792

Fernandez, Hervé

2014-04-01

237

[Uterine leiomyoma].  

Science.gov (United States)

Uterine fibroids, benign tumors of the human uterus, are the most common indication for hysterectomy. They are clinically apparent in 20-25% of women and cause significant complaints, like prolonged and heavy menstruation, pelvic pressure or pain, sometimes reproductive dysfunction. Though surgery has been the mainstay of fibroid treatment, various minimally invasive procedures have been developed in addition to hysterectomy and abdominal myomectomy. Formation of new leiomyomas after these conservative therapies remains a substantial problem. Also drug-therapy methods are available, but the possible side-effects limit their long-term use. Authors attempt to give an overview of this common gynecological disease, yielding a new insight into the basic biology and genetics of fibroids, with the hope of new and effective methods of therapy in the future. PMID:20889441

Csatlós, Eva; Rigó, János; Szabó, István; Nagy, Zsolt; Joó, József Gábor

2010-10-17

238

Primary non-Hodgkin's lymphoma of the uterine cervix: A case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Primary uterine cervical non-Hodgkin's lymphomas (NHL) are rare. Limited experience dictates careful pretherapy evaluation and multidisciplinary approach in treatment planning. A 53-year-old woman presented with postmenopausal bleeding and PAP smear IIIb. Cervical biopsy and endocervical curettage biopsy revealed NHL of the uterine cervix. Abdominal hysterectomy with bilateral adnexectomy was followed by pelvic lymphadenectomy due to lymph node metastasis, 21 months after the primary operatio...

Živaljevi? Milica; Vujkov Tamara; Jovanovi? Darjana V.; Mandi? Aljoša; Mihajlovi? Olgica; Prvulovi? Mladen; Stojiljkovi? Bratislav T.

2004-01-01

239

Adenomyosis with severe inflammation in the uterine cervix in a dog  

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A dog with purulent vulval discharge was found to have many cysts containing purulent mucus in the uterine cervix. The uterine horns did not contain any pus. Histological examination revealed a cervical adenomyosis infiltrated by many neutrophils. After an ovariohysterectomy including the whole cervix, the dog recovered well.

Tamada, Hiromichi; Kawate, Noritoshi; Inaba, Toshio; Kuwamura, Mitsuru; Maeda, Masaya; Kajikawa, Taketsugu; Sawada, Tsutomu

2005-01-01

240

Imaging cervical cancer  

International Nuclear Information System (INIS)

Full text: Uterine cervical cancer is the third most common gynecological malignancy with a wide range of five year survival rate according to the tumor stage. Officially the treatment policy is chosen based on the clinical staging irrespective the substantial body of evidence that MRI is useful in evaluating malignant conditions of the female pelvis. The goal of the presentation is to highlight: 1) The results from screening tests; 2) The role of Imaging staging of cervical cancer; 3) The standard MRI protocol, recommended by the European Society of Uroradiology; 4) The new role of Imaging in guiding an individualized therapy and 5) The assessment of therapy effect. MRI, although not officially incorporated in the FIGO staging system, is already widely accepted as the most reliable imaging technique for the diagnosis, staging, treatment planning, and follow-up of cervical cancer. In summary, MRI plays a key role in staging, patient selection for treatment, and detection of disease recurrence.

2012-11-01

 
 
 
 
241

Ultrastaging of lymph node in uterine cancers  

Directory of Open Access Journals (Sweden)

Full Text Available Abstract Background Lymph node status is an important prognostic factor and a criterion for adjuvant therapy in uterine cancers. While detection of micrometastases by ultrastaging techniques is correlated to prognosis in several other cancers, this remains a matter of debate for uterine cancers. The objective of this review on sentinel nodes (SN in uterine cancers was to determine the contribution of ultrastaging to detect micrometastases. Methods Review of the English literature on SN procedure in cervical and endometrial cancers and histological techniques including hematoxylin and eosin (H&E staining, serial sectioning, immunohistochemistry (IHC and molecular techniques to detect micrometastases. Results In both cervical and endometrial cancers, H&E and IHC appeared insufficient to detect micrometastases. In cervical cancer, using H&E, serial sectioning and IHC, the rate of macrometastases varied between 7.1% and 36.3% with a mean value of 25.8%. The percentage of women with micrometastases ranged from 0% and 47.4% with a mean value of 28.3%. In endometrial cancer, the rate of macrometastases varied from 0% to 22%. Using H&E, serial sectioning and IHC, the rate of micrometastases varied from 0% to 15% with a mean value of 5.8%. In both cervical and endometrial cancers, data on the contribution of molecular techniques to detect micrometastases are insufficient to clarify their role in SN ultrastaging. Conclusion In uterine cancers, H&E, serial sectioning and IHC appears the best histological combined technique to detect micrometastases. Although accumulating data have proved the relation between the risk of recurrence and the presence of micrometastases, their clinical implications on indications for adjuvant therapy has to be clarified.

Uzan Serge

2010-01-01

242

Polypoid uterine lesions mimicking endometrial stromal sarcoma.  

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Two polypoid submucosal uterine lesions were examined histologically and immunohistochemically with monoclonal antibodies to desmin and alpha smooth muscle actin. One case comprised a leiomyoma and the other a polypoid form of adenomyosis. Both polyps had prolapsed through the external cervical os. The lesions had an ulcerated surface with focal areas of marked increased cellularity and pronounced vascularity throughout, such that they mimicked a low grade endometrial stromal sarcoma infiltra...

Mccluggage, W. G.; Alderdice, J. M.; Walsh, M. Y.

1999-01-01

243

Uterine metastasis of invasive ductal breast carcinoma diagnosed by cytological examination in an asymptomatic patient: an unusual case report  

Directory of Open Access Journals (Sweden)

Full Text Available Uterine metastasis of malignant tumors occurs very rarely. Despite abnormal uterine bleeding is the most common symptom of metastatic uterine disease, less than 5% of patients may have not any gynecologic symptoms and diagnosis is made usually following abnormal cervical cytology. Here we present a case of uterine metastasis of invasive ductal breast carcinoma that was diagnosed by cervical cytological examination during breast cancer follow up. Even if there are not any gynecologic symptoms and findings in a patient who has breast cancer history, a detail systematic pelvic examination of these patients must be done yearly.

Ça?da? Türky?lmaz

2007-10-01

244

Uterine Fibroid Embolization  

Medline Plus

Full Text Available Uterine Fibroid Embolization Baptist Health South Florida Miami, FL March 25, 2010 Good afternoon, and welcome to the ... today is going to be an embolization of uterine fibroids. So we're going to show you the ...

245

Cervical pregnancy: a report of four cases.  

Science.gov (United States)

Various conservative treatments for cervical pregnancy have been reported. However, unlike tubal ectopic pregnancy, the treatment of cervical pregnancy has not been well established. For patients who desire fertility preservation, treatment with methotrexate chemotherapy carries a high success rate for preservation of the uterus. When methotrexate is injected i.v. or i.m., expulsion of pregnant tissue occasionally takes up to 1 month. In this report, we present four cases of cervical pregnancy which were successfully managed by methotrexate injection into the bilateral uterine arteries. In cases presenting with massive bleeding, embolization of the bilateral uterine arteries was performed. Cervical pregnancy was aborted within 8 days safely, and fertility could be preserved without harmful side-effects. PMID:24118279

Kochi, Keiko; Hidaka, Takao; Yasoshima, Kuniaki; Yoneda, Kenji; Arai, Kazunori; Arai, Takashi

2014-02-01

246

Modification of conservative treatment of heterotopic cervical pregnancy by Foley catheter balloon fixation with cerclage sutures at the level of the external cervical os: a case report  

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Full Text Available Abstract Introduction Conservative treatment of a heterotopic cervical pregnancy was performed with a modification of the fixation of a Foley catheter at the level of the external cervical os, followed by the ligature of the descending cervical branches of the uterine arteries and systemic methotrexate application. Case presentation A 34-year-old Caucasian woman was diagnosed with double gestation after 6 weeks of in vitro fertilization treatment. A gynecological examination and color Doppler ultrasound scan revealed intra-uterine and cervical gestational sacs both containing live fetuses. A Foley catheter balloon was inserted into the cervical canal, inflated and fixed by a cerclage suture at the level of the external cervical os, followed by ligation of the descending cervical branches of the uterine arteries. Systemic methotrexate was applied. Three days after removal of the Foley catheter, an evacuation of the intra-uterine gestational sac was performed. Hemorrhage from the implantation site was controlled immediately and a pregnancy termination was successfully performed. The procedure was uneventful and our patient was discharged with a preserved uterus. Conclusions Conservative treatment of cervical pregnancy using a Foley catheter balloon is more efficacious if the Foley catheter balloon is attached in the correct position with a cerclage suture at the level of the external os, followed by ligation of the descending cervical branches of the uterine arteries, thereby exerting maximal pressure on the bleeding vessels.

Vujisic Sanja

2010-07-01

247

PREGNANCY OUTCOME FOLLOWING CERVICAL ENCERCLAGE OPERATION  

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Background -Recurrent second trimester abortions and  premature deliveries, continue to be two of the main  problems of modern obstetrics and perinatal medicine . Cervical incompetency or insufficiency is defined as“the inability of the uterine cervix to retain a pregnancy in the absence of contractions or labor. Cervical encerclage is considered as a simple but useful minor surgical procedure for improving the fetal salvage in proven cases of cervica...

Bangal, Vidyadhar B.; Gavhane, Satyajit P.; Khanvelkar, Gayatri K.; Patil, Neha A.

2012-01-01

248

How will HPV vaccines affect cervical cancer?  

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Cancer of the uterine cervix is the second largest cause of cancer deaths in women, and its toll is greatest in populations that lack screening programmes to detect precursor lesions. Persistent infection with ‘high risk’ genotypes of human papillomavirus (HPV) is necessary, although not sufficient, to cause cervical carcinoma. Therefore, HPV vaccination provides an opportunity to profoundly affect cervical cancer incidence worldwide. A recently licensed HPV subunit vaccine protects women...

Roden, Richard; Wu, T. -c

2006-01-01

249

Cervical spondylosis  

Science.gov (United States)

Cervical spondylosis is a disorder in which there is abnormal wear on the cartilage and bones of the neck ( ... Cervical spondylosis is caused by chronic wear on the cervical spine. This includes the disks or cushions between the ...

250

Accurate and economical intracavitary endocurietherapy in the treatment of uterine cervix cancer  

Energy Technology Data Exchange (ETDEWEB)

A modified afterloading cervical applicator and intracavitary endocurietherapy application technique eliminates several problems associated with the Henschke cervical applicator, and conventional preloading technique. The Kumar cervical applicator minimizes patient discomfort, and improves patient mobility while reducing the tendency of the applicator to rotate during the 40 to 50 hours of uterine intracavitary endocurietherapy. The use of hygroscopic laminaria tent for gradual cervical dilatation in place of manual cervical dilatation, and the use of inflatable Foley balloon threaded onto the tandem instead of vaginal packing, to separate the /sup 137/Cesium sources away from the rectum and bladder, eliminate the need of general anesthesia for the majority of patients undergoing intracavitary endocurietherapy.

Kumar, P.P.; Good, R.R.

1986-01-01

251

Progesterone receptor in the human uterine cervix.  

Directory of Open Access Journals (Sweden)

Full Text Available A progesterone receptor (PR in human uterine cervical nuclei was demonstrated by a nuclear exchange assay using a synthetic progestin, promegestone (R5020 as a radio-labeled ligand. Total exchange of previously bound progesterone with R5020 was achieved by incubation at 0 degree C for 3 h. A 0.6 M KCl solution was used to extract the nuclear PR in uterine cervical tissue, and the dextran coated charcoal (DCC method was used to separate the free [3H] R5020 from the bound form. Scatchard plots of nuclear PR binding showed two components with dissociation constants of Kd = 2.3 X 10(-10 and 4.6 X 10(-9 M. Three histological regions of the uterine cervix was studied as to their nuclear PR contents throughout the menstrual cycle. In the follicular phase, the connective tissue (CT had the highest PR concentration (658.9 fmole/mg DNA, followed by the columnar epithelium (CE (253.6 fmole/mg DNA, and the squamous epithelium (SE (184.7 fmole/mg DNA. In the luteal phase, there was no significant difference among the three regions. Comparing these phases of cycle revealed that the CT had higher PR contents in the follicular phase than in the luteal phase, but no such difference was found in the CE or SE. These three regions had the same Kd value in both phases.

Lin,Tai-Tung

1984-02-01

252

Decreased type III collagen expression in human uterine cervix of prolapse uteri.  

Science.gov (United States)

The precise mechanism of prolapse uteri is not fully understood. There is evidence to suggest that abnormalities of collagen, the main component of extracellular matrix, or its repair mechanism, may predispose women to prolapse. To investigate the characteristic structure of human uterine cervix of patients with prolapse uteri, various types of collagen expression in the uterine cervix tissues of the prolapse uteri were compared to those of normal uterine cervix. After informed consent, 36 specimens of uterine cervical tissues were obtained at the time of surgery from 16 postmenopausal women with prolapse uteri (stage III-IV by the Pelvic Organ Prolapse Quantification examination) and 20 postmenopausal women without prolapse uteri (control group). Collagens were extracted from the uterine cervix tissues by salt precipitation methods. The relative levels of various collagens were evaluated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The uterine cervix was longer in the patients with prolapse uteri than those of postmenopausal controls without prolapse uteri. The ratios of type III to type I collagen in the uterine cervical tissues were significantly decreased in the prolapse uteri, as compared to those of the postmenopausal uterine cervix without prolapse. These results suggest that decreased type III collagen expression may play an important role in determing the physiology and structure of the uterine cervix tissues of prolapse uteri. PMID:22977496

Iwahashi, Masaaki; Muragaki, Yasuteru

2011-03-01

253

Unrecognized cervical pregnancy treated by suction curettage and cervicovaginal tamponade.  

Science.gov (United States)

The authors presented a case of a 30-year tertigravidar women with unrecognized cervical pregnancy, treated by suction curettage and cervicovaginal tamponade. In our case of unrecognized cervical pregnancy, during hysterometry and cervical dilatation occured uterine bleeding and clinical pictures of obstetrics hemorrhagic shock, so we continued with suction curettage and cervicovaginal tamponade as a urgent procedure which turned out as a final. Medicamentous chemotherapy of the cervical pregnancy (methotrexat) was not used, because after described procedure beta-HCG lytic decreased and without colour-Doppler visualization of local cervical trophoblastic vascularisation. PMID:12070799

Habek, Dubravko; Habek, Jasna Cerkez; Cur?ik, Darko

2002-03-01

254

Cervical cancer in India--strategy for control.  

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The available information on the incidence of cancers by site in India have indicated that of incidence of cancer of uterine cervix among women is by far the highest compared to other sites in women. The epidemiology of cervical cancer has been studied extensively in India and in other countries. The majority of factors related to cervical cancer are associated with sexual behaviour. The available evidence for control of cervical cancer is through secondary prevention, namely--early detection...

Prabhakar A

1992-01-01

255

Uterine artery embolization to treat uterine fibroids  

International Nuclear Information System (INIS)

The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

2001-06-01

256

The postpartum buffalo: I. Endocrinological changes and uterine involution.  

Science.gov (United States)

To maintain a calving interval of 13-14 months in buffaloes, successful breeding must take place within 85-115 days after calving. Disturbances during this period due to delay of uterine involution or resumption of estrous activity are likely to prolong the calving interval and reduce the lifetime reproductive and productive efficiency. In this article literature on endocrinological changes in the peripartum period and on factors affecting uterine involution are reviewed. The available information indicated that although the availability of releasable FSH does not appear to be a limiting factor for resumption of postpartum cyclicity a substantial increase of releasable LH and replenishment of pituitary stores occurred around Day 20 in dairy and Day 30 in swamp buffaloes. There is evidence that follicular activity is resumed early (15-30 days) in the postpartum period. However, the factors which initiate release of appropriate LH pulses, follicular maturation and ovulation in the postpartum buffalo need further studies. The mean interval to complete uterine involution varied widely between 19 and 52 days. Assessment of cervical and uterine horn diameters by rectal palpation alone is not satisfactory to diagnose delayed uterine involution and possible subclinical uterine infection. Vaginal inspection can be included as a fundamental part of postpartum genital examination for diagnosis of such case. Uterine involution, however, does not seem to be a limiting factor for achievement of satisfactory fertility in the postpartum buffalo but the main determinant is resumption of estrous activity. PMID:16600532

El-Wishy, A B

2007-02-01

257

Dysfunctional uterine bleeding.  

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Abnormal uterine bleeding is a common, debilitating condition. Dysfunctional uterine bleeding (DUB) is the diagnosis given to women with abnormal uterine bleeding in whom no clear etiology can be identified. DUB has been observed in both ovulatory and anovulatory cycles. Medical treatments include nonsteroidal anti-inflammatory drugs, oral contraceptive pills, progestins, danazol (a synthetic androgen), GnRH agonists, and antifibrinolytic drugs. The drawback to medical therapy, in addition to...

Chen, B. H.; Giudice, L. C.

1998-01-01

258

Malignant mixed mullerian tumor arising from the uterine cervix: A case report  

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Malignant mixed mullerian tumors (MMMTs) are a rare uterine tumor and contribute to approximately 1-3% of all corpus malignant tumors. MMMTs are usually in the uterine corpus, but can also arise from the uterine cervix, vagina, ovaries and fallofian tubes. MMMTs of the uterine cervix are extremely rare. MMMTs are highly malignant and tend to maintain a rapid growth and exhibit a high rate of recurrence. Therefore, the prognosis of patients diagnosed with these types of tumors is extremely poor. We report a rare case of a malignant mixed mullerian tumor arising from the uterine cervix and introduce CT and MRI findings. CT and magnetic resonance findings of the uterine cervical MMMT in our case show highly aggressive features, such as parametrial involvement, pelvic and paraaortic lymphadenopathy, and distant metastasis and high enhancement.

Shim, Jong Joon; Shim, Jae Chan; Lee, Kyoung Eun; Lee, Ghi Jai; Kim, Ho Kyun; Suh, Jung Ho; Lee, Hye Kyung [Seoul Paik Hospital/Inje Univ. College of Medicine, Seoul (Korea, Republic of)

2012-10-15

259

Vaginal misoprostol for cervical priming before hysteroscopy  

Directory of Open Access Journals (Sweden)

Full Text Available "nBackground: As an important diagnostic and therapeutic procedure for patients with intrauterine diseases, hysteroscopy permits a good view of the uterine cavity, thereby increasing diagnostic accuracy. Complications often encountered during hysteroscopy primarily concern problems with cervical dilatation and include uterine perforation, cervical tears, and the creation of false tracts. In this study, we investigate the utility of vaginal misoprostol for cervical dilatation in women undergoing hysteroscopy. "nMethods: This triple-blind, randomized, placebo-controlled study was carried out at Mirza Khoochak Khan Hospital, Tehran, Iran. We excluded women who were pregnant, had genital tract infection, or history of cervical trauma. We randomly assigned 80 women with abnormal uterine bleeding or intrauterine lesions to receive either 200 ?g vaginal misoprostol or placebo. Ten to twelve hours prior to hysteroscopy, the placebo or misoprostol was administered to the posterior vaginal fornix. Data regarding cervical response and outcome of operative hysteroscopy, as well as complications, were analyzed. "nResults: The mean cervical width, as estimated by Hegar dilator, was significantly greater in the treated group (7.8±1.6mm than that in the control group (5.6±2.2mm, p<0.001. In the misoprostol group, 28 (70% patients required cervical dilatation, compared with 38(95% in the placebo group (p=0.001. A significantly shorter median time of cervical dilatation to Hegar number 9 was found in the treated subjects than in the controls (60 vs. 180 seconds, p<0.001. The mean operative time was significantly shorter in the treated group (8.8±8.7 minutes compared with that of the control group (13.1±10.1 minutes, p=0.043. "nConclusions: Vaginal misoprostol before operative hysteroscopy lessens the need for cervical dilatation, facilitating hysteroscopic surgery.

Valadan M

2008-11-01

260

Uterine Fibroid Embolization (UFE)  

Science.gov (United States)

... relief of their symptoms. Because the effect of uterine fibroid embolization on fertility is not fully understood, UFE is typically offered ... would be a concern. The question of whether uterine fibroid embolization impacts fertility has not yet been answered, although a number ...

 
 
 
 
261

Uterine cervical carcinoma: a comparison of two- and three-dimensional T2-weighted turbo spin-echo MR imaging at 3.0 T for image quality and local-regional staging  

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To compare three-dimensional (3D) T2-weighted turbo spin-echo (TSE) with multiplanar two-dimensional (2D) T2-weighted TSE for the evaluation of invasive cervical carcinoma. Seventy-five patients with cervical carcinoma underwent MRI of the pelvis at 3.0 T, using both 5-mm-thick multiplanar 2D (total acquisition time = 12 min 25 s) and 1-mm-thick coronal 3D T2-weighted TSE sequences (7 min 20 s). Quantitative analysis of signal-to-noise ratio (SNR) and qualitative analysis of image quality were performed. Local-regional staging was performed in 45 patients who underwent radical hysterectomy. The estimated SNR of cervical carcinoma and the relative tumour contrast were significantly higher on 3D imaging (P < 0.0001). Tumour conspicuity was better with the 3D sequence, but the sharpness of tumour margin was better with the 2D sequence. No significant difference in overall image quality was noted between the two sequences (P = 0.38). There were no significant differences in terms of the diagnostic accuracy, sensitivity, and specificity of parametrial invasion, vaginal invasion, and lymph node metastases. Multiplanar reconstruction 3D T2-weighted imaging is largely equivalent to 2D T2-weighted imaging for overall image quality and staging accuracy of cervical carcinoma with a shorter MR data acquisition, but has limitations with regard to the sharpness of the tumour margin. circle 3D T2-weighted MR sequence is equivalent to 2D for cervical carcinoma staging. (orig.)

Shin, Y.R. [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul (Korea, Republic of); The Catholic University of Korea, Department of Radiology, Incheon St. Mary' s Hospital, College of Medicine, Bupyeong 6-dong, Bupyeong-gu, Incheon (Korea, Republic of); Rha, S.E.; Choi, B.G.; Oh, S.N.; Park, M.Y.; Byun, J.Y. [The Catholic University of Korea, Department of Radiology, Seoul St. Mary' s Hospital, College of Medicine, 222, Banpo-daero, Seocho-gu, Seoul (Korea, Republic of)

2013-04-15

262

Uterine cervical carcinoma: a comparison of two- and three-dimensional T2-weighted turbo spin-echo MR imaging at 3.0 T for image quality and local-regional staging  

International Nuclear Information System (INIS)

To compare three-dimensional (3D) T2-weighted turbo spin-echo (TSE) with multiplanar two-dimensional (2D) T2-weighted TSE for the evaluation of invasive cervical carcinoma. Seventy-five patients with cervical carcinoma underwent MRI of the pelvis at 3.0 T, using both 5-mm-thick multiplanar 2D (total acquisition time = 12 min 25 s) and 1-mm-thick coronal 3D T2-weighted TSE sequences (7 min 20 s). Quantitative analysis of signal-to-noise ratio (SNR) and qualitative analysis of image quality were performed. Local-regional staging was performed in 45 patients who underwent radical hysterectomy. The estimated SNR of cervical carcinoma and the relative tumour contrast were significantly higher on 3D imaging (P < 0.0001). Tumour conspicuity was better with the 3D sequence, but the sharpness of tumour margin was better with the 2D sequence. No significant difference in overall image quality was noted between the two sequences (P = 0.38). There were no significant differences in terms of the diagnostic accuracy, sensitivity, and specificity of parametrial invasion, vaginal invasion, and lymph node metastases. Multiplanar reconstruction 3D T2-weighted imaging is largely equivalent to 2D T2-weighted imaging for overall image quality and staging accuracy of cervical carcinoma with a shorter MR data acquisition, but has limitations with regard to the sharpness of the tumour margin. circle 3D T2-weighted MR sequence is equivalent to 2D for cervical carcinoma staging. (orig.)

2013-04-01

263

Prevalencia de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en el Cauca, Colombia / The prevalence of abnormal cytology and inflammation and their association with risk factors for uterine cervical neoplasms in Cauca, Colombia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Objetivos Establecer la prevalencia del resultado de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en mujeres del departamento del Cauca, Colombia. Metodología Después de la Arma voluntaria del consentimiento informado, las mujeres fueron e [...] ntrevistadas a través de un cuestionario para colectar variables de tipo sociodemográfico y clínico, incluyendo historia reproductiva, actividad sexual, historia de citología y hábito de fumar. Posteriormente, se procedió a la toma de la citología para su análisis y clasificación según el sistema Bethesda 2001. Un total de 1735 mujeres fueron reclutadas para este estudio. Resultados Acorde con el resultado de citología, 1061 mujeres presentaron citología normal (61 %), 36 citología anormal (2 %) y 638 cambios celulares reactivos asociados a inflamación (37 %). Los resultados indican que tener relaciones sexuales a temprana edad, la multiparidad, el uso de anticonceptivos hormonales y no realizarse la citología anualmente fueron factores de riesgo asociados a citología anormal. Conclusiones Estos resultados brindan información valiosa a las instituciones de salud pública para desarrollar mejores programas de cribado para la prevención de neoplasias del cuello uterino en mujeres de la región y el país. Abstract in english Objectives Establishing the prevalence of abnormal and inflammation cytology reports and its association with risks factors for uterine cervical neoplasms amongst females from the Cauca department in Colombia. Methodology After signing a consent-form, females were interviewed using a questionnaire t [...] o collect socio-demographic and clinical data, including reproductive history, sexual activity, cytology history and smoking habits. Cytology was then taken for analysis and classification according to the 2001 Bethesda System. A total of 1,735 females were recruited for the study. Results According to the cytology report, 1061 women had normal cytology (61 %), 36 abnormal cytology (2 %) and 638 reactive cellular changes associated with inflammation (37 %). The results indicated that having sexual intercourse at an early age, multiparity, using hormonal contraceptives and not having annual cytology screening were associated with abnormal cytology reports. Conclusions These results provided valuable information for public health institutions for developing better screening programmes to prevent risks of uterine cervical neoplasms amongst females from our region and throughout Colombia.

Yaliana, Tafurt-Cardona; Claudia P, Acosta-Astaiza; Carlos H, Sierra-Torres.

264

Prevalencia de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en el Cauca, Colombia / The prevalence of abnormal cytology and inflammation and their association with risk factors for uterine cervical neoplasms in Cauca, Colombia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Spanish Abstract in spanish Objetivos Establecer la prevalencia del resultado de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en mujeres del departamento del Cauca, Colombia. Metodología Después de la Arma voluntaria del consentimiento informado, las mujeres fueron e [...] ntrevistadas a través de un cuestionario para colectar variables de tipo sociodemográfico y clínico, incluyendo historia reproductiva, actividad sexual, historia de citología y hábito de fumar. Posteriormente, se procedió a la toma de la citología para su análisis y clasificación según el sistema Bethesda 2001. Un total de 1735 mujeres fueron reclutadas para este estudio. Resultados Acorde con el resultado de citología, 1061 mujeres presentaron citología normal (61 %), 36 citología anormal (2 %) y 638 cambios celulares reactivos asociados a inflamación (37 %). Los resultados indican que tener relaciones sexuales a temprana edad, la multiparidad, el uso de anticonceptivos hormonales y no realizarse la citología anualmente fueron factores de riesgo asociados a citología anormal. Conclusiones Estos resultados brindan información valiosa a las instituciones de salud pública para desarrollar mejores programas de cribado para la prevención de neoplasias del cuello uterino en mujeres de la región y el país. Abstract in english Objectives Establishing the prevalence of abnormal and inflammation cytology reports and its association with risks factors for uterine cervical neoplasms amongst females from the Cauca department in Colombia. Methodology After signing a consent-form, females were interviewed using a questionnaire t [...] o collect socio-demographic and clinical data, including reproductive history, sexual activity, cytology history and smoking habits. Cytology was then taken for analysis and classification according to the 2001 Bethesda System. A total of 1,735 females were recruited for the study. Results According to the cytology report, 1061 women had normal cytology (61 %), 36 abnormal cytology (2 %) and 638 reactive cellular changes associated with inflammation (37 %). The results indicated that having sexual intercourse at an early age, multiparity, using hormonal contraceptives and not having annual cytology screening were associated with abnormal cytology reports. Conclusions These results provided valuable information for public health institutions for developing better screening programmes to prevent risks of uterine cervical neoplasms amongst females from our region and throughout Colombia.

Yaliana, Tafurt-Cardona; Claudia P., Acosta-Astaiza; Carlos H., Sierra-Torres.

265

Prevalencia de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en el Cauca, Colombia The prevalence of abnormal cytology and inflammation and their association with risk factors for uterine cervical neoplasms in Cauca, Colombia  

Directory of Open Access Journals (Sweden)

Full Text Available Objetivos Establecer la prevalencia del resultado de citología anormal e inflamación y su asociación con factores de riesgo para neoplasias del cuello uterino en mujeres del departamento del Cauca, Colombia. Metodología Después de la Arma voluntaria del consentimiento informado, las mujeres fueron entrevistadas a través de un cuestionario para colectar variables de tipo sociodemográfico y clínico, incluyendo historia reproductiva, actividad sexual, historia de citología y hábito de fumar. Posteriormente, se procedió a la toma de la citología para su análisis y clasificación según el sistema Bethesda 2001. Un total de 1735 mujeres fueron reclutadas para este estudio. Resultados Acorde con el resultado de citología, 1061 mujeres presentaron citología normal (61 %, 36 citología anormal (2 % y 638 cambios celulares reactivos asociados a inflamación (37 %. Los resultados indican que tener relaciones sexuales a temprana edad, la multiparidad, el uso de anticonceptivos hormonales y no realizarse la citología anualmente fueron factores de riesgo asociados a citología anormal. Conclusiones Estos resultados brindan información valiosa a las instituciones de salud pública para desarrollar mejores programas de cribado para la prevención de neoplasias del cuello uterino en mujeres de la región y el país.Objectives Establishing the prevalence of abnormal and inflammation cytology reports and its association with risks factors for uterine cervical neoplasms amongst females from the Cauca department in Colombia. Methodology After signing a consent-form, females were interviewed using a questionnaire to collect socio-demographic and clinical data, including reproductive history, sexual activity, cytology history and smoking habits. Cytology was then taken for analysis and classification according to the 2001 Bethesda System. A total of 1,735 females were recruited for the study. Results According to the cytology report, 1061 women had normal cytology (61 %, 36 abnormal cytology (2 % and 638 reactive cellular changes associated with inflammation (37 %. The results indicated that having sexual intercourse at an early age, multiparity, using hormonal contraceptives and not having annual cytology screening were associated with abnormal cytology reports. Conclusions These results provided valuable information for public health institutions for developing better screening programmes to prevent risks of uterine cervical neoplasms amongst females from our region and throughout Colombia.

Yaliana Tafurt-Cardona

2012-02-01

266

Uterine Didelphys with blind hemivagina, hematocolpos, ipsilateral renal agenesis (UD-BHRA) and bilateral ovarian tumors : a case report  

Energy Technology Data Exchange (ETDEWEB)

Uterine didelphys is a congenital malformation characterized by the presence of two separated hemiuteri and hemivaginas, due to lack of midfusion of the mullerian ducts. We report a case of UD-BHRA (uterine didelphys with blind hemivagina and ipsilateral renal agencies), a rare type of uterine dedelphys characterized by symptomatic unilateral hematocolpos due to blind hemivagina after menarche and ipsilateral renal agenesis. The MRI findings in 22-year-old woman with bilateral ovarian tumors demonstrated two separated uterine horns and cervical and vaginal canals, with left hematocolpos and left agenesis. (author). 7 refs., 1 fig.

Lee, Young Rae; Choi, Byung Ik; Park, Hae Won; Kook, Shin Ho [Kangbuk Samsung Hospital, Seoul (Korea, Republic of)

1998-03-01

267

Uterine Didelphys with blind hemivagina, hematocolpos, ipsilateral renal agenesis (UD-BHRA) and bilateral ovarian tumors : a case report  

International Nuclear Information System (INIS)

Uterine didelphys is a congenital malformation characterized by the presence of two separated hemiuteri and hemivaginas, due to lack of midfusion of the mullerian ducts. We report a case of UD-BHRA (uterine didelphys with blind hemivagina and ipsilateral renal agencies), a rare type of uterine dedelphys characterized by symptomatic unilateral hematocolpos due to blind hemivagina after menarche and ipsilateral renal agenesis. The MRI findings in 22-year-old woman with bilateral ovarian tumors demonstrated two separated uterine horns and cervical and vaginal canals, with left hematocolpos and left agenesis. (author). 7 refs., 1 fig

1998-03-01

268

Cervical Cancer Screening  

Science.gov (United States)

... are called diagnostic tests . General Information About Cervical Cancer Cervical cancer is a disease in which malignant (cancer) ... following PDQ summaries for more information about cervical cancer: Cervical Cancer Prevention Cervical Cancer Treatment Screening for cervical ...

269

Cervical Cancer Prevention  

Science.gov (United States)

... keep cancer from starting. General Information About Cervical Cancer Cervical cancer is a disease in which malignant (cancer) ... following PDQ summaries for more information about cervical cancer: Cervical Cancer Screening Cervical Cancer Treatment Screening for cervical ...

270

Uterine fibroids: current perspectives.  

Science.gov (United States)

Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause). There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman's menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy). The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs) and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE) has now been well-recognized as a uterine-sparing (fertility-preserving) method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS) or radiofrequency (VizAblate™ and Acessa™) for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge. PMID:24511243

Khan, Aamir T; Shehmar, Manjeet; Gupta, Janesh K

2014-01-01

271

Uterine Fibroid Embolization  

Directory of Open Access Journals (Sweden)

Full Text Available Uterine fibroids are commonly asymptomatic. They often cause pelvic pain, abnormal and increased vaginal bleeding, etc. Traditional treatment of symptomatic uterine fibroids was trans-abdominal hysterectomy. Nowadays, uterine artery embolization (UAE, also called uterine fibroid embolization, is considered as a safe and highly-effective nonsurgical treatment for women with symptomatic uterine fibroid tumors. Advantages of UAE over conventional hormonal suppression and surgical procedures include avoidance of the side effects of drug therapy and surgery-related physical and psychological trauma. These patients commonly resume their normal activities within a week after the procedure; weeks earlier than that for trans-abdominal hysterectomy. Over the past 30 years, interventional radiologists have done UAE for treatment of emergency uterine bleeding. Since 1995, interventional radiologists have turned their attention to treatment of uterine fibroids with a similar procedure. The first fibroid embolization in Iran was done approximately three years ago. So far, more than 100 cases have been treated by this method and it is going to be quickly accepted as a safe alternate for surgery.

"R. Malek

2003-06-01

272

Uterine cervix carcinoma: pathologic characteristics, treatment and follow-up evaluation  

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Background: Carcinoma of the uterine cervix is the sixth most common malignant neoplasm in women. Early stage diagnosis of uterine cervix carcinoma increases the cure rate of disease. Radiotherapy, with or without concurrent chemotherapy, is one of the most effective treatment modality in cervical carcinoma. After radiotherapy, accurate and regular follow-up results in early diagnosis and effective treatment of recurrence. The aim of this study is the assessment of the pathologic characterist...

2008-01-01

273

Erosive gastritis  

Energy Technology Data Exchange (ETDEWEB)

Erosive gastritis is a well-defined radiologic and endoscopic entity. It is one of the common causes of upper gastrointestinal bleeding, yet it is seldom diagnosed and often confused with a number of other diseases. This communication re-emphasizes the characteristic endoscopic and radiologic features of erosive gastritis and its differential diagnosis. Two representative cases are reported.

Mohammed, S.H.; Conrad, C.; Kjoergaad, J.

1982-08-01

274

Erosive gastritis  

International Nuclear Information System (INIS)

Erosive gastritis is a well-defined radiologic and endoscopic entity. It is one of the common causes of upper gastrointestinal bleeding, yet it is seldom diagnosed and often confused with a number of other diseases. This communication re-emphasizes the characteristic endoscopic and radiologic features of erosive gastritis and its differential diagnosis. Two representative cases are reported. (orig.)

1982-01-01

275

Cervical Laminoplasty  

Science.gov (United States)

... or fractures. Frequently this spinal cord pressure, called spinal stenosis, can occur at multiple levels of the cervical ... showing the cervical spine in a patient with spinal stenosis. Notice the grey spinal cord traveling down from ...

276

Cervical Cancer  

Centers for Disease Control (CDC) Podcasts

Did you know that cervical cancer rates differ by race/ethnicity and region? Or that cervical cancer can usually be prevented if precancerous cervical lesions are found by a Pap test and treated? Find out how getting regular Pap tests can save a woman's life.  Created: 3/6/2007 by National Breast and Cervical Cancer Early Detection Program.   Date Released: 4/25/2007.

2007-03-06

277

The diagnostic value of transvaginal color Doppler ultrasound for cervical diseases  

International Nuclear Information System (INIS)

Objective: To evaluate the diagnostic value of transvaginal color Doppler ultrasound for the cervical diseases. Method: Cases of cervical disease diagnosed and managed from 2003 to 2006 were included. Transvaginal color Doppler sonographic (TVS) findings, clinical treatments, pathologic results were followed up and analyzed. Results 70 cases of cervical disease were identified, including 40 cases of cervical cyst (35cases of Naboth cyst, 3 cases of endometriosis cyst), 5 cases of cervical polyps, 5 cases of cervical fibroma, 2 cases of uterine submucous myoma projecting to cervix, 2 cases of cervical pregnancy, 3 cases of cervical dysfunction, 15 cases of malignant tumor. The ultrasonic diagnosis was accordant to pathologic results in 97% patients. Conclusion: Transvaginal color Doppler ultrasound can make precise diagnosis for cervical diseases. It is the preferred method for the diagnosis of cervical diseases. (authors)

2007-04-01

278

The role of MR imaging in invasive cervical carcinoma  

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In this article the role of MR imaging in the management of cervical cancer is reviewed and illustrated. The appearance of the normal uterine cervix and of cervical carcinoma is shown. Important factors for optimal MR imaging of cervical carcinoma are reviewed. The value of MR imaging in the staging of cervical carcinoma is illustrated by showing parametrial invasion and lymph node involvement. Finally, the value of MR imaging staging is compared with clinical staging, CT staging, and surgical findings. The role of new imaging techniques, such as fast dynamic enhanced MR imaging, is described. (orig.)

Boss, E.A.; Massuger, L.F.A.G.; Boonstra, H. [Dept. of Obstetrics and Gynecology, University Hospital, Nijmegen (Netherlands); Barentsz, J.O. [Dept. of Radiology, University Hospital, Nijmegen (Netherlands)

2000-02-01

279

Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo Evaluation of risk for preterm delivery by measurement of uterine cervix and cervical gland area  

Digital Repository Infrastructure Vision for European Research (DRIVER)

OBJETIVO: verificar a prevalência do sinal eco glandular endocervical (EGE) e o comprimento cervical menor ou igual a 20 mm em gestantes entre a 21ª e a 24ª semana e comparar estes sinais ecográficos como fatores indicadores de parto pré-termo espontâneo. MÉTODOS: estudo prospectivo transversal no qual foram incluídas 361 gestantes da população geral, para realização de exame ultra-sonografico em idade gestacional entre a 21ª a 24ª semana. Os critérios de exclusão do estudo fo...

2004-01-01

280

Usefulness of {sup 18}FDG PET in the management of cervical cancer; Apport de la TEP au {sup 18}FDG dans la prise en charge du cancer du col uterin  

Energy Technology Data Exchange (ETDEWEB)

Cervical carcinoma is the second most common gynaecological cancer worldwide. Despite substantial advances in screening the pre-invasive forms, the management of women suffering from invasive cervical carcinomas remains problematic. In pre-treatment staging, the evaluation of the loco-regional and distant extent of the disease, according to the international federation of gynecology and obstetrics, has shown to be sub-optimal. After treatment, the routine surveillance protocol, based on a physical examination at the control visits and clinically oriented conventional imaging procedures, most often fails to accurately detect a recurrent disease. Its sensitivity is particularly low for asymptomatic women. On the other hand, the clinical value of positron emission tomography using {sup 18}F-fluorodeoxyglucose in the field of oncology is nowadays firmly established. In many tumour types, including the gynaecological cancers such as breast cancer and ovarian cancer, the metabolic imaging has proved to play a determinant role in both the pre-treatment and post-treatment evaluation. In the present review-article, we analyse in the light of the literature data and our experience, the potential contribution of positron emission tomography using {sup 18}F-fluorodeoxyglucose in the management of cervical cancer. (authors)

Belhocine, T.; Rigo, P. [Centre Hospitalier et Universitaire de Liege (Belgium)

2002-09-01

 
 
 
 
281

Postpartum suppression of ovarian activity with a Deslorelin implant enhanced uterine involution in lactating dairy cows.  

Science.gov (United States)

Holstein cows received, subcutaneously a non-degradable implant containing 5mg of the GnRH agonist Deslorelin (DESL) or no implant (CON) at 2+/-1 days postpartum (dpp). All cows were injected with PGF(2alpha) at 9 dpp. Previous pregnant (PPH) and non-pregnant uterine horns (PNPH) were determined by palpation per rectum. In Experiment 1, cows [DESL implant (n=10) and CON (n=9)] were examined by ultrasonography to record ovarian structures (23, 30 and 37 dpp) and uterine horn and cervical diameters (16, 23, 30 and 37 dpp). Uterine tone was scored before ultrasonography. Vaginoscopy was conducted just after ultrasonography examination to assess cervical discharge and color of the external cervical os. Blood samples were collected on a weekly basis for hormonal analyses. In Experiment 2, cows [DESL implant (n=77) and CON (n=70)] were palpated per rectum and vaginoscopy at 30 dpp for scoring of uterine tone, uterine horns, cervical diameter, and discharge. Blood samples were collected only at 9 dpp. In Experiment 1, DESL-implant-treated cows had more Class 1 follicles (P<0.01), less Class 2 (P<0.01) and Class 3 follicles (P<0.01) and no corpus luteum (CL) formation (P<0.01). In CON cows, six of nine animals had visible CL at 25+/-7 dpp. At 9 dpp plasma concentration of E(2), P(4) (P<0.01) and PGFM (P<0.05) were less in the DESL-implant treatment group. Diameter of PPH (P<0.01), PNPH (P<0.01) and cervix (P=0.08) were less in the DESL-implant treatment associated with greater uterine tone (P=0.07). The DESL-implant cows had a greater frequency of clear cervical discharge (P=0.09) and pink cervical os (P=0.06). In Experiment 2, plasma concentrations of PGFM were less at 9 dpp in DESL-implant treatment (P<0.01). Diameters of the PPH (P<0.01) and PNPH (P<0.01) were less and more uterine tone (P<0.01) in the DESL-implant treatment. Diameter of cervix and frequency of a cervical discharge score did not differ between treatments. Treatment with non-degradable Deslorelin (5mg) implant during postpartum: (1) suppressed ovarian follicular development, (2) enhanced physical involution of the uterus and cervix, (3) increased tone of the uterine wall, (4) decreased frequency of purulent cervical discharges, and (5) reduced inflammatory processes of the reproductive tract. PMID:18243603

Silvestre, F T; Bartolome, J A; Kamimura, S; Arteche, A C; Pancarci, S M; Trigg, T; Thatcher, W W

2009-01-01

282

Uterine Fibroid Embolization  

Medline Plus

Full Text Available Uterine Fibroid Embolization Baptist Health South Florida Miami, FL March 25, 2010 Good afternoon, and welcome to the Baptist Cardiac and Vascular Institute here in Miami, Florida. ...

283

Symptoms of Uterine Cancer  

Science.gov (United States)

... Announcements Radio Public Service Announcements Print Materials Campaign Research Doctors Who Use Social Media Poster Presentation Buttons and Badges Related Resources Gynecologic Cancer Symptoms Diary [PDF-503KB] Uterine Cancer fact sheet [PDF-622KB] ...

284

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... surgery in the United States. And the commonest reason that that surgery occurs is for uterine fibroids. ... the hospital overnight for the recovery. And the reason we do that is because after the procedure ...

285

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... we have been part of a number of clinical research trials to investigate how safe this is ... and fall into the uterine cavity, in which case we would refer you back to your gynecologist ...

286

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... has very symptomatic uterine fibroids, very heavy menstrual periods. Her periods last on the order of eight days, four ... painful intercourse, and very heavy and crampy menstrual periods. If we can come to our diagram here, ...

287

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... got just to where that artery starts to branch off. And then, using that special small micro- ... in that main uterine artery, but the little branches no longer have flow. So that's our first ...

288

Pure uterine lipoma.  

Science.gov (United States)

Pure uterine lipoma is a very rare benign mesenchymal neoplasm, and only a few cases have been reported in the literature. This is in contrast to leiomyoma, which is not only the most common neoplasm of the uterus but also one of the most common tumours in women, estimated to occur in 20-40% of women beyond the age of 30 years (AFIP) and more frequently affect postmenopausal women. We report the case of a 70-year-old woman who presented with pelvic pain and postmenopausal uterine bleeding. Pure uterine lipoma was diagnosed preoperatively by CT scan with and without contrast and confirmed postoperatively by pathological examination. Clinical and histological diagnosis of pure uterine lipoma with immunohistochemical findings are described,and the efficacy of CT in diagnosing this tumour is discussed. PMID:23858948

Imenpour, H; Petrogalli, F; Anselmi, L

2013-02-01

289

Uterine Fibroid Embolization  

Medline Plus

Full Text Available Uterine Fibroid Embolization Baptist Health South Florida Miami, FL March 25, 2010 Good afternoon, and welcome to the Baptist Cardiac and Vascular Institute here in Miami, Florida. I'm ...

290

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... as it shrinks parts of it can actually break off and fall into the cavity. And a ... some of this fibroid, instead of shrinking, may break off and fall into the uterine cavity, in ...

291

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... a young woman. She's 31 years old. She has very symptomatic uterine fibroids, very heavy menstrual periods. ... is a catheter, very similar to what he has in the vessel. And if I show you, ...

292

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... is a very abnormal uterine artery, the very rich blood supply. And that is typical of a ... tumor. But as a tumor, it has that rich blood supply. And, of course, that's what causes ...

293

[Advanced uterine prolapse during pregnancy: pre- and postnatal management].  

Science.gov (United States)

Pelvic organ prolapse is a common pelvic floor disorder in postmenopausal women. The literature is quite poor concerning the management of prolapse during pregnancy in young women. We report the case of a 39-year-old multiparous woman referred for the treatment of an exteriorized uterine prolapse at 13 weeks of gestation. The management of cervical prolapse depends on its stage, its evolution and on gestational age. It combines local antiseptics, rest and manual reintegration or reduction of the prolapsus using a pessary to prevent ulceration of the cervix. In case of stage IV (POP-Q) uterine prolapse, vaginal delivery may be compromised. No recommendation is actually available about route of delivery in case of exteriorized uterine prolapse. It should be clearly discussed regarding the potential risk of cesarean section for dystocia. Surgical repair of the prolapse will be discussed after childbirth according to functional impairment and women's desire for pregnancy. PMID:23867760

Pizzoferrato, A-C; Bui, C; Fauconnier, A; Bader, G

2013-01-01

294

Avaliação da medida do comprimento do colo e da ausência do eco glandular endocervical para predição do parto pré-termo / Evaluation of risk for preterm delivery by measurement of uterine cervix and cervical gland area  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: verificar a prevalência do sinal eco glandular endocervical (EGE) e o comprimento cervical menor ou igual a 20 mm em gestantes entre a 21ª e a 24ª semana e comparar estes sinais ecográficos como fatores indicadores de parto pré-termo espontâneo. MÉTODOS: estudo prospectivo transversal no q [...] ual foram incluídas 361 gestantes da população geral, para realização de exame ultra-sonografico em idade gestacional entre a 21ª a 24ª semana. Os critérios de exclusão do estudo foram malformações müllerianas, gestações múltiplas, malformações fetais, óbito fetal, alterações da quantidade de líquido amniótico, placenta com inserção segmentar, antecedentes de cirurgia no colo uterino (conização, amputação, cerclagem) e procedimentos cirúrgicos durante a gestação. Após a realização do exame ultra-sonográfico obstétrico morfológico efetuado por via abdominal, seguiu-se o exame ecográfico por via vaginal para observação de uma faixa hipoecóica ou hiperecóica adjacente ao canal endocervical correpondente às glândulas do epitélio endocervical (EGE) e mensuração do comprimento cervical. As variáveis qualitativas são representadas por freqüência absoluta e relativa, ao passo que as variáveis quantitativas, por média, desvio-padrão, mediana e valores mínimo e máximo. A associação entre as variáveis qualitativas foi avaliada pelo teste c² ou teste exato de Fisher. Para cada variável estudada, foi calculado o risco relativo seguido do intervalo com 95% de confiança. A técnica de análise de regressão logística univariada foi utilizada para verificar, entre as variáveis estudadas, quais foram indicativas de parto pré-termo espontâneo. O nível de significância adotado foi de 95% (alfa = 5%) e descritivos (p) iguais ou inferiores a 0,05 foram considerados significantes. RESULTADOS: a incidência do parto pré-termo espontâneo foi de 5,0%. O comprimento do colo uterino revelou-se igual ou inferior a 20 mm em 3,3% da população estudada e em 27,8% das pacientes que apresentaram parto pré-termo espontâneo. A ausência do EGE foi detectada em 2,8% das pacientes estudadas e em 44,4% das pacientes que evoluíram para parto pré-termo espontâneo. A associação entre ausência do EGE e presença do colo curto revelou-se estatisticamente significante (p Abstract in english PURPOSE: to verify the prevalence of two sonographic findings, the cervical gland area (CGA) feature and the cervical length of less than 20 mm, and to compare these with the risk for premature delivery in pregnant women between 21 and 24 weeks' gestation. METHOD: this was a prospective, cross-secti [...] onal study in which 361 women were consecutively examined by transvaginal ultrasonography. Müllerian or other malformations, multiple gestations, fetal death, olygo- or polyhydramnios, marginal placenta previa, and conization, cerclage, amputation or other surgical procedures in the cervix, prior to or during pregnancy, were exclusion criteria. After the abdominal ultrasonographic morphological examination, we used transvaginal ultrasonography to measure the cervical length and to observe the presence of hyper- or hypoechoic area next to the endocervical canal, a feature characteristic of endocervical epithelium glands which is called CGA (cervical gland area). Qualitative variables are expressed as absolute and relative frequency. Quantitative variables are expressed as mean, median, standard deviation, minimum, and maximum values. Association between qualitative variables was detected by the c² test or by the Fisher exact test. For each variable, the relative risk and the 95% confidence interval (CI) were calculated. Logistic regression analysis was used to calculate the predictive values for premature delivery. Significance level was 95% (alpha = 5%), with descriptive (p) values equal or lower than 0.05 considered significant. RESULTS: spontaneous preterm delivery occurred in 5.0% of the patients. Cervical

Claudio Rodrigues, Pires; Antonio Fernandes, Moron; Rosiane, Mattar; Luiz, Kulay Júnior.

295

Uterine fibroids: current perspectives  

Directory of Open Access Journals (Sweden)

Full Text Available Aamir T Khan,1 Manjeet Shehmar,1 Janesh K Gupta21Birmingham Women's Hospital, Edgbaston, Birmingham, UK; 2Academic Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham, UKAbstract: Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause. There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman's menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy. The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE has now been well-recognized as a uterine-sparing (fertility-preserving method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS or radiofrequency (VizAblate™ and Acessa™ for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge.Keywords: leiomyoma, menorrhagia, ultrasonography, selective progesterone receptor modulators, uterine artery embolization, myomectomy

Khan AT

2014-01-01

296

Dysfunctional Uterine Bleeding  

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Dysfunctional uterine bleeding (DUB) is defined as abnormal uterine bleeding that results from an ovarian endocrinopathy. It may be associated with ovulatory and anovulatory cycles. The diagnosis of DUB depends on a thorough history and physical examination to exclude organic disorders. In older women, endometrial biopsy should be done before starting therapy. The treatment depends on an understanding of the menstrual cycle. In less urgent cases, anovulatory cycles are managed using progester...

Livingstone, Verity H.

1987-01-01

297

Prevalência do exame preventivo de câncer do colo do útero em Rio Branco, Acre, Brasil, e fatores associados à não-realização do exame / Prevalence of uterine cervical cancer testing in Rio Branco, Acre State, Brazil, and factors associated with non-participation in screening  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Portuguese Abstract in portuguese O objetivo do estudo foi determinar a prevalência autorreferida do exame preventivo de câncer do colo uterino em Rio Branco, Acre, Brasil, e avaliar fatores associados com a não realização do exame. Trata-se de estudo transversal de base populacional, composto por 772 mulheres de 18 a 69 anos reside [...] ntes em Rio Branco, no período 2007 a 2008. Os dados foram analisados no programa Stata 10.0 e estimadas razões de prevalências a partir da regressão multivariada de Poisson. O percentual de mulheres na população alvo que relatou pelo menos um exame nos últimos três anos foi de 85,3%, com acentuada utilização do Sistema Único de Saúde (72,8%). Foram encontradas razões de prevalência estatisticamente significativas quanto à ausência do exame em mulheres de 18 a 24 anos, de 60 a 69 anos, solteiras, com menor renda e baixa escolaridade. As magnitudes encontradas nas razões de prevalência foram consistentes com achados de outros estudos, apontando maior necessidade de intervenção no grupo de mulheres mais vulneráveis à incidência e mortalidade por câncer do colo do útero. Abstract in english The objective of the study was to determine the self-reported prevalence of uterine cervical cancer testing in Rio Branco, Acre State, Brazil, and to analyze factors associated with non-participation in screening. A population-based cross-sectional study with a sample of 772 women 18 to 69 years of [...] age and living in Rio Branco was conducted in 2007 and 2008. Data were analyzed with Stata 10.0, and prevalence rates were estimated with Poisson multivariate regression (95%CI). 85.3% of women reported at least one cervical cancer screening test in the previous three years. The majority of women (72.8%) were screened in the Brazilian Unified National Health System. After adjusting for selected variables, statistically significant prevalence rates for absence of screening were found in women 18-24 and 60-69 years of age, single, and with low income and low schooling. The prevalence rates were consistent with findings from other studies, highlighting the need for greater intervention in the group of women most vulnerable to cervical cancer incidence and mortality.

Maria Fernanda de Sousa Oliveira, Borges; Leila Maria Geromel, Dotto; Rosalina Jorge, Koifman; Margarida de Aquino, Cunha; Pascoal Torres, Muniz.

298

Prevalência do exame preventivo de câncer do colo do útero em Rio Branco, Acre, Brasil, e fatores associados à não-realização do exame / Prevalence of uterine cervical cancer testing in Rio Branco, Acre State, Brazil, and factors associated with non-participation in screening  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O objetivo do estudo foi determinar a prevalência autorreferida do exame preventivo de câncer do colo uterino em Rio Branco, Acre, Brasil, e avaliar fatores associados com a não realização do exame. Trata-se de estudo transversal de base populacional, composto por 772 mulheres de 18 a 69 anos reside [...] ntes em Rio Branco, no período 2007 a 2008. Os dados foram analisados no programa Stata 10.0 e estimadas razões de prevalências a partir da regressão multivariada de Poisson. O percentual de mulheres na população alvo que relatou pelo menos um exame nos últimos três anos foi de 85,3%, com acentuada utilização do Sistema Único de Saúde (72,8%). Foram encontradas razões de prevalência estatisticamente significativas quanto à ausência do exame em mulheres de 18 a 24 anos, de 60 a 69 anos, solteiras, com menor renda e baixa escolaridade. As magnitudes encontradas nas razões de prevalência foram consistentes com achados de outros estudos, apontando maior necessidade de intervenção no grupo de mulheres mais vulneráveis à incidência e mortalidade por câncer do colo do útero. Abstract in english The objective of the study was to determine the self-reported prevalence of uterine cervical cancer testing in Rio Branco, Acre State, Brazil, and to analyze factors associated with non-participation in screening. A population-based cross-sectional study with a sample of 772 women 18 to 69 years of [...] age and living in Rio Branco was conducted in 2007 and 2008. Data were analyzed with Stata 10.0, and prevalence rates were estimated with Poisson multivariate regression (95%CI). 85.3% of women reported at least one cervical cancer screening test in the previous three years. The majority of women (72.8%) were screened in the Brazilian Unified National Health System. After adjusting for selected variables, statistically significant prevalence rates for absence of screening were found in women 18-24 and 60-69 years of age, single, and with low income and low schooling. The prevalence rates were consistent with findings from other studies, highlighting the need for greater intervention in the group of women most vulnerable to cervical cancer incidence and mortality.

Maria Fernanda de Sousa Oliveira, Borges; Leila Maria Geromel, Dotto; Rosalina Jorge, Koifman; Margarida de Aquino, Cunha; Pascoal Torres, Muniz.

299

Sarcoma botryoides (embryonal rhabdomyosarcoma) of the uterine cervix in sisters  

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Sarcoma botryoides (embryonal rhabdomyosarcoma) rarely arises in the uterine cervix. We report a case of a 14-year-old female with sarcoma botryoides who presented with prolonged vaginal bleeding and cervical polyp. The biopsy specimen confirmed sarcoma botryoides. The patient underwent radical surgery of the tumor and hysterectomy without adjuvant chemotherapy. The sister of the patient had died previously due to the same diagnosis at the age of 17. We achieved a satisfactory outcome in shor...

2010-01-01

300

Long-term follow-up of neoadjuvant intraarterial chemotherapy using an original four-lumen double-balloon (4L-DB) catheter for locally advanced uterine cervical cancer  

International Nuclear Information System (INIS)

We report the therapeutic potential, long-term survival, and toxicity of neoadjuvant intraarterial chemotherapy (NAIC) using an original four-lumen double-balloon (4L-DB) catheter followed by radical hysterectomy and/or radiotherapy in patients with locally advanced cervical cancer. Sixty patients with stage IIB-IVA cervical squamous cell cancer were treated with NAIC which included cisplatin (60-70 mg/m2, day 1), mitomycin-C (10-20 mg/m2, day 1), and pirarubicin hydrochloride (THP; 10-20 mg/m2, day 1) for two courses every 21 days. The median follow up among surviving patients was 93.7 months. Among 60 eligible patients, 22 had a complete response (CR; 36.7%) including 12 with a pathologic CR (20.0%). Thirty-six patients had a partial response (60.0%), and stable disease was observed in only 2 patients (3.3%). Moreover, we found that the platinum concentration in the cervix was correlated with the clinical response (P<0.001). The 10-year progression-free survival (PFS) and 10-year survival were 90.9% and 90.9%, respectively, in patients with stage IIB disease and 66.0% and 70.7%, respectively, in patients with stage III disease. Leukopenia occurred in 86.7% of patients, but it was not very severe (grade 3, 4 in 13.3% of patients). Our results with NAIC using the 4L-DB catheter in locally advanced cervical cancer demonstrate that a high platinum concentration has beneficial effects on primary lesions and improves long-term progression-free and overall survival. (author)

2009-02-01

 
 
 
 
301

Modification of conservative treatment of heterotopic cervical pregnancy by Foley catheter balloon fixation with cerclage sutures at the level of the external cervical os: a case report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Introduction Conservative treatment of a heterotopic cervical pregnancy was performed with a modification of the fixation of a Foley catheter at the level of the external cervical os, followed by the ligature of the descending cervical branches of the uterine arteries and systemic methotrexate application. Case presentation A 34-year-old Caucasian woman was diagnosed with double gestation after 6 weeks of in vitro fertilization treatment. A gyn...

Hafner Tomislav; Ivkosic Ivana; Serman Alan; Bauman Renato; Ujevic Boris; Vujisic Sanja; Hafner Daria; Miskovic Berivoj

2010-01-01

302

Acute puerperal uterine inversion  

International Nuclear Information System (INIS)

Objective: To determine the frequency, causes, clinical presentations, management and maternal mortality associated with acute puerperal inversion of the uterus. Materials and Methods: All the patients who developed acute puerperal inversion of the uterus either in or outside the JPMC were included in the study. Patients of chronic uterine inversion were not included in the present study. Abdominal and vaginal examination was done to confirm and classify inversion into first, second or third degrees. Results: 57036 deliveries and 36 acute uterine inversions occurred during the study period, so the frequency of uterine inversion was 1 in 1584 deliveries. Mismanagement of third stage of labour was responsible for uterine inversion in 75% of patients. Majority of the patients presented with shock, either hypovolemic (69%) or neurogenic (13%) in origin. Manual replacement of the uterus under general anaesthesia with 2% halothane was successfully done in 35 patients (97.5%). Abdominal hysterectomy was done in only one patient. There were three maternal deaths due to inversion. Conclusion: Proper education and training regarding placental delivery, diagnosis and management of uterine inversion must be imparted to the maternity care providers especially to traditional birth attendants and family physicians to prevent this potentially life-threatening condition. (author)

2004-04-01

303

Cervical dilation in second-trimester abortion.  

Science.gov (United States)

Dilation and evacuation, the most common method performed for second-trimester abortion in the United States, requires sufficient cervical dilation to reduce the risk of complications such as cervical laceration or uterine perforation. The cervix may be prepared with osmotic dilators such as laminaria, Lamicel, or Dilapan-S, or with pharmacologic agents such as misoprostol. Dilapan-S and Lamicel achieve their maximum dilation faster than laminaria, making same-day procedures possible. Misoprostol has limited data supporting its use in this setting. Decisions regarding which method is best are clinician-dependent, and factors such as gestational age and time allowed for preparation should be considered. PMID:19407523

Hayes, Jennifer L; Fox, Michelle C

2009-06-01

304

Pure uterine lipoma.  

Science.gov (United States)

Lipomatous tumors of the uterus are unusual, benign neoplasms seen in postmenopausal women. Although many of the mixed-type cases such as lipoleiomyoma and fibrolipoma have been reported, pure uterine lipomas are extremely rare. In the literature, a few cases with pure uterine lipoma have been reported. We first present the advanced magnetic resonance findings of pure uterine lipoma, followed by those of ultrasonography (US) and computed tomography (CT). We markedly detected lipid peaks on the magnetic resonance spectroscopy (MRS) and the apparent diffusion coefficient value to be 0.00 due to chemical-shift effects with diffusion-weighted imaging (DWI). Although pelvic lipomatous tumors can be diagnosed with US and CT, in some cases, further workup may be required to localize the lesion. MRI may yield more valuable data for differential diagnosis. MRS and DWI findings provide additional clues on the nature of the lesion. PMID:17905250

Erdem, Gulnur; Celik, Onder; Karakas, Hakki Muammer; Alkan, Alpay; Hascalik, Seyma

2007-10-01

305

Dysfunctional uterine bleeding.  

Science.gov (United States)

Abnormal uterine bleeding is a common, debilitating condition. Dysfunctional uterine bleeding (DUB) is the diagnosis given to women with abnormal uterine bleeding in whom no clear etiology can be identified. DUB has been observed in both ovulatory and anovulatory cycles. Medical treatments include nonsteroidal anti-inflammatory drugs, oral contraceptive pills, progestins, danazol (a synthetic androgen), GnRH agonists, and antifibrinolytic drugs. The drawback to medical therapy, in addition to side effects, is that the benefit lasts only while the patient takes the medication. Surgical options have concentrated mainly on endometrial ablation and hysterectomy, and it is unclear whether one is superior to the other in terms of long-term outcome and patient satisfaction. Newer and less invasive ablation techniques, such as thermal balloon ablation, offer more treatment alternatives. PMID:9830356

Chen, B H; Giudice, L C

1998-11-01

306

Dosimetric comparison of IMRT and modulated arc-therapy techniques in the treatment of cervical cancers; Comparaison dosimetrique des techniques de RCMI et d'arctherapie modulee dans le traitement des cancers du col uterin  

Energy Technology Data Exchange (ETDEWEB)

The authors report the dosimetric comparison of two techniques used for the treatment of cervical cancers: the intensity-modulated conformational radiotherapy (IMRT) with static beams and modulated arc-therapy with RapidArc. The treatment plans of 15 patients have been compared. The clinical target volume (CTV) comprises the gross target volume, the cervix, the upper third of the vagina, and ganglionary areas. The previsional target volume comprises the clinical target volume and a one centimetre margin. Organs at risk are rectum, bladder, intestine and bone marrow. Arc-therapy seems to provide a better sparing of intestine that IMRT, while maintaining a good coverage of the previsional target volume and decreasing treatment duration. Short communication

Renard-Oldrini, S.; Charra-Brunaud, C.; Tournier-Rangeard, L.; Huger, S.; Marchesi, V.; Bouziz, D.; Peiffert, D. [Centre Alexis-Vautrin, Nancy (France)

2011-10-15

307

Induction of labor using double balloon cervical device in women with previous cesarean section: Experience and review  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Induction of labour remains one of the most challenging interventions in current obstetrics. Different pharmaceuticals have been used for cervical ripening such as prostaglandins; however they can lead to a number of potential inconvenient risks namely uterine tachysystole and pathological fetal cardiotocography (CTG). In cases of women with previous caesarean births, using prostaglandins would pose even higher risks such as uterine rupture and p...

Ebeid, E.; Nassif, N.

2013-01-01

308

CRYOTHERAPY IN CERVICAL INTRAEPITHELIAL NEOPLASIA  

Directory of Open Access Journals (Sweden)

Full Text Available Cryotherapy is a time proven ablative method of treating lower grades of cervical dysplasia. It  is done using compressed CO2 or N2O refrigerant with the aim of creating an ice ball with a depth of freeze denoted by a peripheral margin of 4-5 mm of frost. It is performed using a double freeze or single freeze technique. Currently the double freeze technique of cryotherapy is an accepted treatment for mild and focal moderate dysplasia of the uterine cervix. The success of cryotherapy is determined by five factors : patient anatomy, pathology, equipment, technique and physician skill. Here we have a brief review of cryotherapy as an effective modality in treatment of lower grades of cervical intraepithelial neoplasias.

Naina Kumar

2013-01-01

309

A rare case of minimal deviation adenocarcinoma of the uterine cervix in a renal transplant recipient.  

LENUS (Irish Health Repository)

INTRODUCTION: We report the first described case of minimal deviation adenocarcinoma of the uterine cervix in the setting of a female renal cadaveric transplant recipient. MATERIALS AND METHODS: A retrospective review of this clinical case was performed. CONCLUSION: This rare cancer represents only about 1% of all cervical adenocarcinoma.

Fanning, D M

2009-02-03

310

A rare case of minimal deviation adenocarcinoma of the uterine cervix in a renal transplant recipient.  

LENUS (Irish Health Repository)

INTRODUCTION: We report the first described case of minimal deviation adenocarcinoma of the uterine cervix in the setting of a female renal cadaveric transplant recipient. MATERIALS AND METHODS: A retrospective review of this clinical case was performed. CONCLUSION: This rare cancer represents only about 1% of all cervical adenocarcinoma.

Fanning, D M

2012-02-01

311

Cervical neuroblastoma  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Cervical neuroblastoma is relatively uncommon. It present, most often as a firm mass in the lateral neck. Primary neuroblastomas of the neck usually arise in the cervical sympathetic ganglia. They are the sixth most common head and neck extracranial neoplasms. Neuroblastoma is the most common malignancy in children under 1 year of age. No known cause of Neuroblastoma has been reported.

Singh, Harjitpal; Mohan, C.; Mohindroo, N. K.; Sharma, D. R.

2007-01-01

312

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... 1,000 uterine fibroid embolizations. Fibroids are common, benign tumors in women. They can range in size from ... they're not causing a problem. These are benign tumors. They're non-cancerous tumors. So if you ...

313

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... cooperation with us. This is a young woman. She's 31 years old. She has very symptomatic uterine fibroids, very heavy menstrual ... the order of eight days, four of which she's really quite miserable, missing work. And she's really ...

314

Cervical fusion  

International Nuclear Information System (INIS)

The diagnosis of stability of a cervical fusion is best evaluated in a dynamic manner. With use of a 1.5-T General Electric Signa magnetic resonance (MR) imager, ten patients with surgical fusions were evaluated with a series of midsagittal cervical gradient echo-recalled MR images obtained through their range of cervical extension, from a flexed format and in a dynamic cine mode. The fusion was readily evaluated. Additional motion traditionally causes early degenerative disk disease and osteophytic ridging at the levels adjacent to the fused segments

1988-12-02

315

Erosion protection  

International Nuclear Information System (INIS)

All earth dams require protection against erosion due to wave action on the upstream slope and protection against runoff from rain, snowmelt or wave splash on the downstream shell. Erosion protection is a major cost factor in embankment dams, typically varying from 5-15% of the dam cost, although it can approach 50% of embankment cost for long low dikes. The most common type of erosion protection is dumped rock riprap. Current practice in riprap design is based on rational analysis of factors affecting riprap stability, and the performance of existing riprap protection. Historical development of riprap design is reviewed, beginning with U.S. Army Corps of Engineers dams in the 1940s. Riprap design parameters are based on slope steepness and severity of wave action, which depends on reservoir geometry and location. A common cause of riprap deterioration is loss of underlying bedding as a result of inadequate design or segregation of riprap and bedding during construction. The most common form of riprap failures include: loss of filter material through riprap if it is too fine; inadequate rock size to resist wave action, resulting in beaching; segregation during construction, resulting in pockets of undersized rock which can expose the underlying filter, and pockets of oversized rock through which bedding can wash out; breakdown of poor quality stone due to prolonged exposure and wave action; and failure to extend the primary riprap far enough downslope to be below the level of wave action at low reservoir levels. 26 refs., 8 figs

1989-09-01

316

Accurate and economical intracavitary endocurietherapy in the treatment of uterine cervix cancer  

International Nuclear Information System (INIS)

A modified afterloading cervical applicator and intracavitary endocurietherapy application technique eliminates several problems associated with the Henschke cervical applicator, and conventional preloading technique. The Kumar cervical applicator minimizes patient discomfort, and improves patient mobility while reducing the tendency of the applicator to rotate during the 40 to 50 hours of uterine intracavitary endocurietherapy. The use of hygroscopic laminaria tent for gradual cervical dilatation in plate of manual cervical dilatation, and the use of inflatable Foley balloon threaded onto the tandem instead of vaginal packing, to separate the "1"3"7Cesium sources away from the rectum and bladder, eliminate the need of general anesthesia for the majority of patients undergoing intracavitary endocurietherapy. (orig.)

1986-01-01

317

The cervical spine in patients with psoriatic arthritis: a clinical, radiological and immunogenetic study.  

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The radiological changes of the cervical spine were evaluated in 57 patients with psoriatic arthritis and were correlated with clinical, radiological, and immunogenetic features of the disease. Forty patients (70%) showed radiological evidence of the cervical spine being affected by the disease. Two patterns of cervical spine abnormalities were noted. Fifteen patients (26%) had erosive and/or subluxing cervical rheumatoid like lesions; 25 patients (44%) had a more frequently reported pattern ...

Salvarani, C.; Macchioni, P.; Cremonesi, T.; Mantovani, W.; Battistel, B.; Rossi, F.; Capozzoli, N.; Baricchi, R.; Portioli, I.

1992-01-01

318

Studies on the diagnosis of uterine tumor by 201-thallium-chloride  

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Cases of gynecological tumor mainly uterine benign and malignant tumors were evaluated using /sup 201/Thallium-Chloride (/sup 201/Tl-Cl) after intravenous injection. The positive scans of 100% in 42 cases of uterine myoma including 29 cases of leiomyoma, 8 cases of adenomyosis and 5 cases of combined type myoma, also 100% in 8 cases of body cancer indicating adenocarcinoma and 25% in 12 cases of cervical cancer indicating squamous cell carcinoma were observed. The smallest focal lesion for the positive scans was needed approximately more 5 cm in diameter in the cases of leiomyoma. The most accumulation of activities was shown in adenomyosis or adenocarcinoma with much adenoid structure in the pathological study. Accumulation of /sup 201/Tl in uterine benign and malignant tumors was suggested the analog of potassium. The mechanism of tumor affinity was correlated to perfusion volume and the acceleration of the potassium metabolism in a tumor. On the other hand, we suggested the diagnosis of the malignant uterine tumor should be attended due to /sup 201/Tl accumulation also in the benign uterine tumor. The uterine scanning using /sup 201/Tl-Cl was acknowledged to be very useful and safe indicating early detection at 20 minutes after the injection, (non-traumatic procedure and non-visualized bone tissues). In conclusion, this radioisotopical procedure was indicated to be a high value screening examination in the diagnosis of uterine tumor.

Tobari, C.; Muroi, K.; Watanabe, H.; Noguchi, S.; Kurosawa, H. (Toho Univ., Tokyo (Japan). School of Medicine)

1981-10-01

319

Studies on the diagnosis of uterine tumor by 201-thallium-chloride  

International Nuclear Information System (INIS)

Cases of gynecological tumor mainly uterine benign and malignant tumors were evaluated using _2_0_1Thallium-Chloride (_2_0_1Tl-Cl) after intravenous injection. The positive scans of 100% in 42 cases of uterine myoma including 29 cases of leiomyoma, 8 cases of adenomyosis and 5 cases of combined type myoma, also 100% in 8 cases of body cancer indicating adenocarcinoma and 25% in 12 cases of cervical cancer indicating squamous cell carcinoma were observed. The smallest focal lesion for the positive scans was needed approximately more 5 cm in diameter in the cases of leimyoma. The most accumulation of activities was showed in adenomyosis or adenocarcinoma with much adenoid structure in the pathological study. Accumulation of _2_0_1Tl in uterine benign and malignant tumors was suggested the analog of potassium. The mechanism of tumor affinity was correlated to perfusion volume and the acceleration of the potassium metabolism in a tumor. On the other hand, we suggested the diagnosis of the malignant uterine tumor should be attended due to _2_0_1Tl was accumulation also in the benign uterine tumor. The uterine scanning using _2_0_1Tl-Cl was acknowledged to be very useful and safe indicating early detection at 20 minutes after the injection, (non-traumatic procedure and non-visualized bone tissues). In conclusion, this radioisotopical procedure was indicated high value of screening examination in the diagnosis of uterine tumor. (author)

1981-01-01

320

Cervical Cancer  

Science.gov (United States)

CervicalCancer Vagina Fallopian Tubes Ovaries Uterus Cervix Vulva Get the Facts About Gynecologic Cancer There are five main types ... end of the uterus. The cervix connects the vagina (the birth canal) to the upper part of ...

 
 
 
 
321

Cervical Cancer  

Science.gov (United States)

... cancer? A: Two kinds of vaccines (Cervarix and Gardasil) can protect girls and young women against the ... HPV that cause most cervical cancers. Cervarix and Gardasil are licensed, safe, and effective for females ages ...

322

Radiculopatía cervical  

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Full Text Available La patología cervical traumática y su relación con el quehacer de la medicina legal tiene gran importancia y vigencia, principalmente cuando se hace necesario realizar valoraciones a pacientes con alteraciones cervicales y se debe definir si estas están en relación a un trauma determinado o repetitivo en el tiempo como puede ocurrir en algunos casos de riesgos de trabajo. El médico forense debe estar muy bien preparado, conocer la anatomía cervical y de los miembros superiores, realizar un interrogatorio y un examen físico neurológico exhaustivo para orientar las posibilidades diagnósticas; es fundamental además el análisis de los estudios diagnósticos. En este caso en particular se realizará una revisión de la radiculopatía cervical, su fisiopatología, mecanismos de producción y las implicaciones médico legales al realizar la valoración en pacientes con cervicobraquialgiaTraumatic cervical pathology and its relationship to the work of forensic medicine is of great importance and relevance, especially when it is necessary to make assessments in patients with cervical changes and must be defined if they are in relation to a specific trauma or repetitive in time as may occur in some cases of occupational hazards. The medical examiner must be very well prepared, know the anatomy of the cervical and upper limbs, perform an examination and a thorough neurological physical examination to guide the diagnostic possibilities, it is also fundamental analysis of diagnostic studies. In this particular case there will be a review of cervical radiculopathy, pathophysiology, mechanisms of production and the medico-legal implications when doing the assessment in patients with cervical braquial pain

Adriana Murillo Calderón

2012-09-01

323

Uterine fibroid embolization  

International Nuclear Information System (INIS)

Full text: Introduction: Today, after numerous lengthy randomized trials embolization of uterine fibroids has become a standard treatment. Percutaneous embolization of myomas is a micro - invasive surgery, which can be regarded as an alternative to traditional surgery. Although these data 2/3 of the patients were not informed about this treatment option. What you will learn: The uterine embolization is minimal invasive non-surgical procedure. It is an alternative treatment to surgery. Under local anesthesia in the femoral artery puncture reaches the internal iliac artery and uterine arteries. Reached selectively by the catheter and chemicals, which causes clogging, are injected into them. In the vessels that feed fibroids occur a process like an attack, the feeding stops, it starts to shrink and it is replaced by fibrous tissue. The blood vessels of the healthy tissue are different in size and have a plurality of collateral connections as opposed to those of the myoma and thus the blood supply to the normal tissue of the uterus is not distorted. Discussion: Nowadays there are more well- calibrated materials for embolization and those with a particle size of about 700µ are proven as the most successful. The procedure is well tolerated, but after a pain occurs, which has to be covered with anesthetics. Usually pain and metrorrhagia disappear immediately. The fibroids themselves shrink to varying degrees. Hospital stay was significantly shorter than that after surgery, and remained fertile power. Complications are few and rare require further treatment. Multiple nodes are problematic and it is difficult to detect the primary one. A three and six months tracking by MRI is desirable. Conclusion: Embolization of uterine myoma is an established method of treatment primarily on clinical symptoms resulting therefrom. In all patients rapidly disappear metrorrhagia symptoms and morbidity, the volume of the assembly decrease, which together with shorter hospital stays and fertility preservation is well accepted by patients and therefore it is a good alternative to surgery

2013-09-26

324

Intra uterine growth restriction  

Digital Repository Infrastructure Vision for European Research (DRIVER)

In the beginning of the 20th century, the only explanation that was offered to a small baby born was that of prematurity. Fetal growth was defined by birth weight alone. The concept that a fetus might suffer poor growth in utero became recognized in the 1960's. In 1963 Lubchenco and colleagues showed that the classification of neonates by birth weight percentile had a significant prognostic advantage. This classification improved the detection of neonates with intra uterine growth restriction...

Du Plessis, Narina

2012-01-01

325

Distribution of HPV genotypes in cervical intraepithelial lesions and cervical cancer in Tanzanian women  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abstract Background Infection with human papillomavirus (HPV) is associated with uterine cervical intraepithelial neoplasia (CIN) and invasive cancers (ICC). Approximately 80% of ICC cases are diagnosed in under-developed countries. Vaccine development relies on knowledge of HPV genotypes characteristic of LSIL, HSIL and cancer; however, these genotypes remain poorly characterized in many African countries. To contribute to the characterization of HPV genotypes in Northeaster...

Vidal Adriana C; Murphy Susan K; Hernandez Brenda Y; Vasquez Brandi; Bartlett John A; Oneko Olola; Mlay Pendo; Obure Joseph; Overcash Francine; Smith Jennifer S; van der Kolk Mike; Hoyo Cathrine

2011-01-01

326

Evidence for benefits from treating cervical ectopy: literature review / Evidências de benefícios no tratamento de ectopia do colo do útero: revisão de literatura  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO E OBJETIVO: A ectopia do colo do útero é hoje considerada um fenômeno fisiológico, mas parece ainda haver uma forte tendência no sentido da intervenção (tratamento). Este estudo se propõe a realizar revisão da literatura buscando evidências de benefícios conseqüentes ao tratamento da ectopi [...] a. MÉTODOS: Pesquisa nas bases Medical Literature Analysis and Retrieval Sysem Online (Medline), Excerpta Medica Database (Embase), Literatura Latino-Americane e do Caribe em Ciências da Saúde (Lilacs), Biblioteca Cochrane e seis livros especializados. RESULTADOS: A revisão mostrou que: 1) existe provavelmente associação de ectopia com infecção cervical por Chlamydia trachomatis, pelo vírus HPV e maior risco de soroconversão para HIV; 2) existe provavelmente associação entre ectopia e neoplasia intra-epitelial cervical; 3) existe associação com mucorréia e nictúria; 4) não existem evidências sobre associação entre ectopia e câncer de colo do útero nem sobre proteção contra este câncer proporcionada pelo tratamento da ectopia. CONCLUSÕES: 1) Não foram encontrados na literatura dados que justifiquem o tratamento rotineiro da ectopia; 2) O tratamento pode ser utilizado para tratar sintomas associados à ectopia, porém mais sintomas são atribuídos à ectopia do que se pôde confirmar em um estudo controlado; 3) Seriam necessários novos estudos para testar a hipótese de proteção contra o câncer de colo proporcionada pelo tratamento. Abstract in english CONTEXT AND PURPOSE: Uterine cervical ectopy (cervical erosion) is today considered to be a physiological condition, but there still seems to be a strong tendency towards treating it. The purpose of this study was to review the medical literature for evidence regarding benefits from treating cervica [...] l ectopy. METHODS: The following databases were reviewed: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica Database (Embase), Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs) and Cochrane Library databases. In addition, six medical textbooks were consulted. RESULTS: The review showed that: 1) there is probably an association between ectopy and higher risk of Chlamydia trachomatis, human papillomavirus and human immunodeficiency virus infection; 4) there is probably an association between ectopy and cervical intraepithelial neoplasia; 5) there is an association between ectopy and mucous discharge and nocturia; and 6) there is no evidence of an association between ectopy and cervical cancer, or of protection against cervical cancer associated with ectopy treatment. CONCLUSIONS: 1) No data were found in the medical literature to support routine treatment for ectopy; 2) Treatment could be recommended for symptom relief, but more symptoms are attributed to ectopy than could be demonstrated in a controlled study; 3) Further studies to test the hypothesis of protection against cervical cancer associated with treatment are necessary.

Luís Carlos, Machado Junior; Ana Sílvia Whitaker, Dalmaso; Heráclito Barbosa de, Carvalho.

327

Cervical thymoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO: O timoma cervical é neoplasia primitiva do timo. Sua incidência é muito rara. Esta doença apresenta maior incidência em pacientes do sexo feminino, entre a quarta e sexta décadas. RELATO DE CASO: Apresentamos o caso de uma paciente do sexo feminino, 54 anos, com timoma cervical. Durante o [...] período de dois anos e meio de investigação teve evolução assintomática com crescimento progressivo do nódulo cervical, próximo à tireóide. A paciente não apresentou alterações dos exames de função tireoidiana ou dos exames subsidiários realizados. O diagnóstico de timoma cervical foi realizado no intra-operatório sendo conclusivo com o estudo anatomopatológico da peça retirada. O timoma cervical é raro, com difícil diagnóstico pré-operatório. Atualmente utiliza-se métodos complementares para o diagnóstico preciso como: a cintilografia com Tálio 201, o Tecnésio 99 e o Iodo 131, além da ressonância nuclear magnética e, principalmente, realizando o estudo e classificação histopatológica. Abstract in english CONTEXT: Cervical thymoma is a primitive thymic neoplasia. It is very rare. This disease presents higher incidence in female patients in their 4th to 6th decade of life. We present a case report of a cervical thymoma CASE REPORT: 54-year-old female patient, caucasian, with no history of morbidity, p [...] resenting a left cervical nodule close to the thyroid gland. During the 30 months of investigation a left cervical nodule grew progressively next to the thyroid while the patient showed no symptoms, making accurate diagnosis difficult. Tests on her thyroid function did not show changes, nor were there changes in any subsidiary tests. The diagnosis of the disease was made intra-operatively through total thyroid individualization. The results were confirmed by the histological findings from the ressected material. Cervical thymoma is a very rare disease, with difficult preoperatory diagnosis. Some additional study methods which are employed today are thallium 201, technetium 99 and iodine 131 scintigraphy, magnetic nuclear resonance and especially histopathological findings and classification.

Rapoport, Abrão; Dias, Claudiane Ferreira; Freitas, João Paulo Aché de; Souza, Ricardo Pires de.

328

Educação em saúde para prevenção do câncer de colo do útero em mulheres do município de Santo Ângelo/RS / Education in health for prevention of uterine cervical cancer in women in Santo Ângelo, state of Rio Grande do Sul, Brazil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Public Health | Language: Portuguese Abstract in portuguese No Brasil, o câncer cérvico-uterino constitui importante problema de saúde, pois apresenta alto índice de letalidade entre mulheres de varias idades. O exame citopatológico foi preconizado como medida de prevenção deste tipo de câncer, devendo ser realizado a partir do início da vida sexual. O estud [...] o teve um caráter prático de promover educação em saúde sexual e conhecer o perfil da saúde sexual de mulheres de Santo Ângelo/RS. As palestras abordaram formas de prevenção e identificação de possíveis sintomas da doença. O levantamento do perfil de saúde sexual das participantes foi realizado através da aplicação de um questionário estruturado. Participaram das palestras 140 mulheres com idades entre 15 e 60 anos. Verificou-se que, mesmo enfrentando dificuldades e medo, a maioria delas realiza exame preventivo, motivada por aparecimento de sintomas e pelo hábito de cuidar da saúde. As participantes referiram a importância da integração entre profissionais e educadores em Saúde. O estudo foi direcionado no sentido de dar relevância à promoção da saúde e à prevenção do câncer, buscando evitar a doença e obter melhores condições de vida para as mulheres. Abstract in english In Brazil, cervical uterine cancer is a major public health problem as it has high mortality rate indices among women of different ages. A cytopathological examination is recommended for preventing this type of cancer from the early stages of a woman's reproductive life. The scope of this study was [...] both to give talks on sexual health education and establish the sexual health profile of women from St. Angelo/RS. The lectures included measures for prevention as well as identification of possible symptoms of the disease. The research into the sexual health profile of the participants was conducted by a structured questionnaire applied to 140 women aged between 15 and 60. It was found that even experiencing difficulties and apprehension, the majority of the women performed the preventive examination. The motivation for taking the exam is the appearance of symptoms and the habit of caring for their health. The participants mentioned the importance of health professionals and educators working together. The study sought to promote health and cancer prevention, seeking to avoid the disease and ensure better living conditions for women.

Casarin, Micheli Renata; Piccoli, Jaqueline da Costa Escobar.

329

Educação em saúde para prevenção do câncer de colo do útero em mulheres do município de Santo Ângelo/RS Education in health for prevention of uterine cervical cancer in women in Santo Ângelo, state of Rio Grande do Sul, Brazil  

Directory of Open Access Journals (Sweden)

Full Text Available No Brasil, o câncer cérvico-uterino constitui importante problema de saúde, pois apresenta alto índice de letalidade entre mulheres de varias idades. O exame citopatológico foi preconizado como medida de prevenção deste tipo de câncer, devendo ser realizado a partir do início da vida sexual. O estudo teve um caráter prático de promover educação em saúde sexual e conhecer o perfil da saúde sexual de mulheres de Santo Ângelo/RS. As palestras abordaram formas de prevenção e identificação de possíveis sintomas da doença. O levantamento do perfil de saúde sexual das participantes foi realizado através da aplicação de um questionário estruturado. Participaram das palestras 140 mulheres com idades entre 15 e 60 anos. Verificou-se que, mesmo enfrentando dificuldades e medo, a maioria delas realiza exame preventivo, motivada por aparecimento de sintomas e pelo hábito de cuidar da saúde. As participantes referiram a importância da integração entre profissionais e educadores em Saúde. O estudo foi direcionado no sentido de dar relevância à promoção da saúde e à prevenção do câncer, buscando evitar a doença e obter melhores condições de vida para as mulheres.In Brazil, cervical uterine cancer is a major public health problem as it has high mortality rate indices among women of different ages. A cytopathological examination is recommended for preventing this type of cancer from the early stages of a woman's reproductive life. The scope of this study was both to give talks on sexual health education and establish the sexual health profile of women from St. Angelo/RS. The lectures included measures for prevention as well as identification of possible symptoms of the disease. The research into the sexual health profile of the participants was conducted by a structured questionnaire applied to 140 women aged between 15 and 60. It was found that even experiencing difficulties and apprehension, the majority of the women performed the preventive examination. The motivation for taking the exam is the appearance of symptoms and the habit of caring for their health. The participants mentioned the importance of health professionals and educators working together. The study sought to promote health and cancer prevention, seeking to avoid the disease and ensure better living conditions for women.

Micheli Renata Casarin

2011-09-01

330

Educação em saúde para prevenção do câncer de colo do útero em mulheres do município de Santo Ângelo/RS / Education in health for prevention of uterine cervical cancer in women in Santo Ângelo, state of Rio Grande do Sul, Brazil  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese No Brasil, o câncer cérvico-uterino constitui importante problema de saúde, pois apresenta alto índice de letalidade entre mulheres de varias idades. O exame citopatológico foi preconizado como medida de prevenção deste tipo de câncer, devendo ser realizado a partir do início da vida sexual. O estud [...] o teve um caráter prático de promover educação em saúde sexual e conhecer o perfil da saúde sexual de mulheres de Santo Ângelo/RS. As palestras abordaram formas de prevenção e identificação de possíveis sintomas da doença. O levantamento do perfil de saúde sexual das participantes foi realizado através da aplicação de um questionário estruturado. Participaram das palestras 140 mulheres com idades entre 15 e 60 anos. Verificou-se que, mesmo enfrentando dificuldades e medo, a maioria delas realiza exame preventivo, motivada por aparecimento de sintomas e pelo hábito de cuidar da saúde. As participantes referiram a importância da integração entre profissionais e educadores em Saúde. O estudo foi direcionado no sentido de dar relevância à promoção da saúde e à prevenção do câncer, buscando evitar a doença e obter melhores condições de vida para as mulheres. Abstract in english In Brazil, cervical uterine cancer is a major public health problem as it has high mortality rate indices among women of different ages. A cytopathological examination is recommended for preventing this type of cancer from the early stages of a woman's reproductive life. The scope of this study was [...] both to give talks on sexual health education and establish the sexual health profile of women from St. Angelo/RS. The lectures included measures for prevention as well as identification of possible symptoms of the disease. The research into the sexual health profile of the participants was conducted by a structured questionnaire applied to 140 women aged between 15 and 60. It was found that even experiencing difficulties and apprehension, the majority of the women performed the preventive examination. The motivation for taking the exam is the appearance of symptoms and the habit of caring for their health. The participants mentioned the importance of health professionals and educators working together. The study sought to promote health and cancer prevention, seeking to avoid the disease and ensure better living conditions for women.

Casarin, Micheli Renata; Piccoli, Jaqueline da Costa Escobar.

331

Potentialities in integral care: uterine cervical cancer prevention according to the users of the family health strategy / Potencialidades no atendimento integral: a prevenção do câncer do colo do útero na concepção de usuárias da estratégia saúde da família / Potencialidades en la atención integral: prevención de cáncer de cuello uterino de acuerdo con las usuarias de la estrategia salud de la familia  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese O objetivo deste estudo foi analisar o atendimento integral nas práticas de prevenção do câncer do colo do útero na concepção de usuárias da Estratégia Saúde da Família. Foi realizada pesquisa exploratória e descritiva com abordagem qualitativa dos dados. Foram selecionadas quatorze usuárias que rea [...] lizaram o exame Papanicolaou no mês de dezembro de 2002 em quatro Unidades de Saúde da Família, vinculadas a instituições de nível superior. Os dados foram coletados no período de abril a junho de 2003. Como resultado foi observado que as usuárias analisam e avaliam a práxis emitindo juízo de valor à assistência recebida, principalmente, no que se refere às tecnologias leves (relacionais). Conclui-se que práticas humanizadas com responsabilização profissional/equipe favorecem cuidado integral fortalecendo o vínculo das usuárias com os serviços de saúde e a promoção da saúde. Abstract in spanish El objetivo de este estudio fue analizar la atención integral dentro de las prácticas de prevención de cáncer de cuello uterino bajo la concepción de las usuarias de la Estrategia Salud de la Familia. Investigación de tipo exploratorio y descriptivo con enfoque cualitativo. Fueron seleccionadas cato [...] rce usuarias quienes realizaron el examen de Papanicolao durante el mes de diciembre de 2002, en cuatro Servicios de Salud de la Familia vinculados a Instituciones de Enseñanza Superior. La recolección de datos fue realizados entre abril y junio de 2003. Los resultados demuestran que las usuarias analizan y evalúan la atención recibida formando su opinión, en especial, con relación a las tecnologías leves (de relación). Se concluye que las prácticas humanizadas con responsabilidad profesional/equipo favorecen al cuidado integral, fortaleciendo el vínculo entre las usuarias con los servicios y la promoción de la salud. Abstract in english This study aimed to analyze the integral care in the uterine cervical cancer prevention practices in the conception of users of the Family Health Strategy through an exploratory and descriptive research with a qualitative approach. A total of 14 users who performed the Pap smear in December 2002 in [...] four Family Health Units affiliated to Higher Education institutions were selected for the study. Data were collected between April and June 2003. We found that the users analyze and assess the praxis by issuing a value judgment about the care they receive, mainly in terms of light (relational) technologies. Concluding, humanized practices provided by professional/team favor integral care, strengthening the bond between users and health services, as well as health promotion.

Michele Mandagará de, Oliveira; Ione Carvalho, Pinto; Valéria Cristina Christello, Coimbra.

332

Potentialities in integral care: uterine cervical cancer prevention according to the users of the family health strategy Potencialidades en la atención integral: prevención de cáncer de cuello uterino de acuerdo con las usuarias de la estrategia salud de la familia Potencialidades no atendimento integral: a prevenção do câncer do colo do útero na concepção de usuárias da estratégia saúde da família  

Directory of Open Access Journals (Sweden)

Full Text Available This study aimed to analyze the integral care in the uterine cervical cancer prevention practices in the conception of users of the Family Health Strategy through an exploratory and descriptive research with a qualitative approach. A total of 14 users who performed the Pap smear in December 2002 in four Family Health Units affiliated to Higher Education institutions were selected for the study. Data were collected between April and June 2003. We found that the users analyze and assess the praxis by issuing a value judgment about the care they receive, mainly in terms of light (relational technologies. Concluding, humanized practices provided by professional/team favor integral care, strengthening the bond between users and health services, as well as health promotion.El objetivo de este estudio fue analizar la atención integral dentro de las prácticas de prevención de cáncer de cuello uterino bajo la concepción de las usuarias de la Estrategia Salud de la Familia. Investigación de tipo exploratorio y descriptivo con enfoque cualitativo. Fueron seleccionadas catorce usuarias quienes realizaron el examen de Papanicolao durante el mes de diciembre de 2002, en cuatro Servicios de Salud de la Familia vinculados a Instituciones de Enseñanza Superior. La recolección de datos fue realizados entre abril y junio de 2003. Los resultados demuestran que las usuarias analizan y evalúan la atención recibida formando su opinión, en especial, con relación a las tecnologías leves (de relación. Se concluye que las prácticas humanizadas con responsabilidad profesional/equipo favorecen al cuidado integral, fortaleciendo el vínculo entre las usuarias con los servicios y la promoción de la salud.O objetivo deste estudo foi analisar o atendimento integral nas práticas de prevenção do câncer do colo do útero na concepção de usuárias da Estratégia Saúde da Família. Foi realizada pesquisa exploratória e descritiva com abordagem qualitativa dos dados. Foram selecionadas quatorze usuárias que realizaram o exame Papanicolaou no mês de dezembro de 2002 em quatro Unidades de Saúde da Família, vinculadas a instituições de nível superior. Os dados foram coletados no período de abril a junho de 2003. Como resultado foi observado que as usuárias analisam e avaliam a práxis emitindo juízo de valor à assistência recebida, principalmente, no que se refere às tecnologias leves (relacionais. Conclui-se que práticas humanizadas com responsabilização profissional/equipe favorecem cuidado integral fortalecendo o vínculo das usuárias com os serviços de saúde e a promoção da saúde.

Michele Mandagará de Oliveira

2007-06-01

333

Malignant transformation of uterine leiomyoma  

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A rare case of malignant transformation of uterine leiomyoma is reported. A 54 year old lady, nulliparous and 2 years postmenopausal presented to gynecology clinic with a pelvi – abdominal mass and ultrasound scan suggestive of multiple uterine fibroid. Total abdominal hysterectomy performed. Histopathology report showed leiomyosarcomative changes from benign leiomyoma within the huge mass.

Al Ansari, Afaf A.; Al Hail, Fatima A.; Abboud, Emad

2012-01-01

334

Lajjalu treatment of uterine prolapse.  

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Mimosa pudica was found useful in cases of uterine prolapse with bleeding, consistent with my experience of working with the condition for more than 45 years, and treating hundreds of such cases of uterine prolapse. Hysterectomy has been avoided up to this date, and is not now expected to be recommended. PMID:21836800

Shivanandaiah, T M; Indudhar, T M

2010-04-01

335

Lajjalu treatment of uterine prolapse  

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Mimosa pudica was found useful in cases of uterine prolapse with bleeding, consistent with my experience of working with the condition for more than 45 years, and treating hundreds of such cases of uterine prolapse. Hysterectomy has been avoided up to this date, and is not now expected to be recommended.

2010-01-01

336

Postoperative radiotherapy for carcinoma of the uterine cervix  

International Nuclear Information System (INIS)

During the period between 1972 and 1978, 226 patients were operated on for carcinoma of the uterine cervix at Hiroshima University, and 91 patients were treated by postoperative external irradiation. Patients with lymph node metastasis showed markedly lower five-year survival rates stage I: 44.4%; stage II: 45.0%) than those without lymph node metastasis (99.3% and 84.0%, respectively). In view of benefits of postoperative radiotherapy in the treatment of cervical cancer, only to the node positive and tumor rest patients is recommended. (author)

1985-01-01

337

Cervical Cancer – A Review Article  

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Full Text Available Cervical Cancer is malignant Carcinoma type of cancer originate in cervix region. The cervix is the narrow portion of the uterus where it joins with the top of the vagina. Most cervical cancers are squamous cell carcinomas, arising in the squamous (flattened epithelial cells that line the cervix. Adenocarcinoma, arising in glandular epithelial cells is the second most common type. Very rarely, cancer can arise in other types of cells in the cervix. Cancer refers to a class of diseases in which a cell or a group of cells divide and replicate uncontrollably, intrude into adjacent cells and tissues (invasion and ultimately spread to other parts of the body than the location at which they arose (metastasis (National Cancer Institute 2009. In cervical cancer, (cancer of the uterine cervix, cancer develops in the tissues of the cervix, which is a part of the female reproductive system. The cervix connects the upper body of the uterus to the vagina. The endocervix (the upper part which is close to the uterus is covered by glandular cells, and the ectocervix (the lower part which is close to the vagina is covered by squamous cells. The transformation zone refers to the place where these two regions of the cervix meet (American Cancer Society 2009.

Gunjan Jadon

2012-07-01

338

Cervical tumors.  

Science.gov (United States)

Imaging the cervix for benign and malignant disease can be achieved using transvaginal ultrasound, computed tomography (CT), magnetic resonance imaging, and 18-fluorodeoxyglucose positron emission tomography. The best established role of imaging is in cervical carcinoma where magnetic resonance imaging, CT and increasingly positron emission tomography-CT are the most frequently used imaging modalities. These have a role in staging, treatment selection, recurrent disease, and imaging complications of treatment. Histopathological diagnosis of cervical disorders cannot be made on the basis of imaging alone but certain imaging features may provide an indication as to the underlying diagnosis. We describe the imaging features of some malignant tumor subtypes in which a preoperative diagnosis may alter management. Benign lesions of the cervix are usually detected incidentally or during investigations for dysfunctional vaginal bleeding. We describe the imaging features of the commonly encountered benign cervical lesions. PMID:20974359

Sahdev, Anju

2010-10-01

339

PET in uterine malignancies  

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Positron Emission Tomography (PET) or integrated PET/Computed Tomography (PET/CT) with 18F-Fluoro-Deoxy-Glucose (18F-FDG) is a functional imaging modality, useful in the characterization of undetermined morphological findings, and in the staging/re-staging of a large number of malignancies. Although its use in uterine malignancies has been poorly investigated, in recent years the employment of this technique has constantly increased. In this review, we evaluate the role of PET (/CT) with 18FF...

2010-01-01

340

Cervical cancer  

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Worldwide, cervical cancer is the second most common cancer in women. In the UK, incidence fell after the introduction of the cervical screening programme to the current level of approximately 3200 cases and 1000 deaths a year.About 80% of tumours are squamous type, and staging is based on the FIGO classification.Survival ranges from almost 100% 5-year disease-free survival for treated stage Ia disease to 5-15% in stage IV disease. Survival is also influenced by tumour bulk, age, and comor...

Sundar, Sudha Sudesh; Horne, Amanda; Kehoe, Sean

2006-01-01

 
 
 
 
341

Cervical stenosis following electrosurgical conization / Estenose cervical após conização eletrocirúrgica  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO E OBJETIVO: A estenose cervical é uma complicação pós-operatória dos procedimentos para tratamento das lesões pré-invasivas do colo uterino e assume importância particular tanto pelas repercussões clínicas associadas como pela limitação causada nos acompanhamentos citológico e colposcópico. [...] O objetivo foi verificar a incidência da estenose cervical em uma coorte de pacientes submetidas a conização eletrocirúrgica do colo uterino e apontar possíveis fatores prognósticos associados. TIPO DE ESTUDO E LOCAL: Estudo retrospectivo, observacional realizado no Instituto Fernandes Figueira, Departamento de Ginecologia, Rio de Janeiro, Brasil. MÉTODOS: Estudo observacional em uma coorte de pacientes submetidas à conização eletrocirúrgica do colo uterino. As variáveis possivelmente preditoras foram analisadas de forma bivariada entre os grupos com e sem estenose. Calculou-se também a razão de taxas de incidência-densidade da estenose cervical para cada variável possivelmente preditora e os respectivos intervalos de confiança (95%). O nível de significância considerado foi de 5%. RESULTADOS: Foram incluídas 274 pacientes submetidas a conização eletrocirúrgica do colo uterino com um tempo mínimo de seis meses de acompanhamento após o procedimento. A incidência bruta de estenose cervical foi de 7,66% e a incidência-densidade foi de 3,3/1000 pacientes-mês. Não houve diferença estatisticamente significativa entre as características clínico-demográficas dos grupos. CONCLUSÃO: Não se encontrou associação entre as variáveis e a estenose, porém observou-se um nível de significância limítrofe em relação às complicações hemorrágicas do peri e pós-operatório (p = 0,089). Abstract in english CONTEXT AND OBJECTIVE: Cervical stenosis is a postoperative complication of procedures for treating preinvasive lesions of the cervix and takes on particular importance due to the clinical repercussions associated with it. Furthermore, it causes limitations in relation to cytological and colposcopic [...] follow-up. The aim here was to assess the incidence of cervical stenosis among a cohort of patients who underwent electrosurgical conization and to identify possible prognostic factors associated with its occurrence. DESIGN AND SETTING: Retrospective study at Gynecology and Obstetrics Department, Instituto Fernandes Figueira, Rio de Janeiro. METHODS:This was an observational study among a cohort of patients who underwent electrosurgical conization of the uterine cervix. The possible predictive variables were analyzed as bivariate means between the groups with and without stenosis. We also calculated the incidence density rate ratio for cervical stenosis in relation to each possible predictive variable and the respective confidence intervals (95%). Levels of 5% were considered significant. RESULTS: 274 patients who underwent electrosurgical conization of the uterine cervix with a minimum follow-up period of six months were included. The crude incidence of cervical stenosis was 7.66% and the incidence density was 3.3/1,000 patients-month. CONCLUSIONS: We did not find associations between the variables for stenosis. However, we observed borderline significance levels relating to hemorrhagic complications before and after the operation (p = 0.089).

Monteiro, Aparecida Cristina Sampaio; Russomano, Fábio Bastos; Camargo, Maria José de; Silva, Kátia Silveira da; Veiga, Fernanda Rangel; Oliveira, Rebecca Guimarães.

342

Uterine neoplasms, version 1.2014.  

Science.gov (United States)

Adenocarcinoma of the endometrium (also known as endometrial cancer or more broadly as uterine cancer or carcinoma of the uterine corpus) is the most common malignancy of the female genital tract in the United States. An estimated 49,560 new uterine cancer cases will occur in 2013, with 8190 deaths resulting from the disease. Uterine sarcomas (stromal/mesenchymal tumors) are uncommon malignancies, accounting for approximately 3% of all uterine cancers. The NCCN Guidelines for Uterine Neoplasms describe malignant epithelial carcinomas and uterine sarcomas; each of these major categories contains specific histologic groups that require different management. This excerpt of these guidelines focuses on early-stage disease. PMID:24586086

Koh, Wui-Jin; Greer, Benjamin E; Abu-Rustum, Nadeem R; Apte, Sachin M; Campos, Susana M; Chan, John; Cho, Kathleen R; Cohn, David; Crispens, Marta Ann; Dupont, Nefertiti; Eifel, Patricia J; Fader, Amanda Nickles; Fisher, Christine M; Gaffney, David K; George, Suzanne; Han, Ernest; Huh, Warner K; Lurain, John R; Martin, Lainie; Mutch, David; Remmenga, Steven W; Reynolds, R Kevin; Small, William; Teng, Nelson; Tillmanns, Todd; Valea, Fidel A; McMillian, Nicole; Hughes, Miranda

2014-02-01

343

Analysis of TSG101 tumour susceptibility gene transcripts in cervical and endometrial cancers  

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Carcinoma of the uterine cervix is a common malignancy among women that has been found to show loss of heterozygosity in the chromosome 11p. Recent studies have localized the TSG101 gene in this region, and also demonstrated a high frequency of abnormalities of this gene in human breast cancer. To determine the role of the TSG101 gene in the carcinogenesis of cervical and uterine carcinoma, 19 cases of cervical carcinoma and five cases of endometrial carcinoma, as well as nearby non-cancerous...

Chang, J-g; Su, T-h; Wei, H-j; Wang, J-c; Chen, Y-j; Chang, C-p; Jeng, C-j

1999-01-01

344

Association of Induction of Labor and Uterine Rupture in Women attempting Vaginal Birth After Cesarean: A Survival Analysis  

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Objective To estimate the risk of uterine rupture associated with labor induction in women attempting trial of labor after cesarean (TOLAC) accounting for length of labor. Methods Nested case-control study of women attempting TOLAC within a multicenter retrospective cohort study of women with a prior cesarean. Time-to-event analyses were performed with time zero defined as the first cervical exam of 4-cm. Subjects experienced the event (uterine rupture) or were censored (delivered). Results One-hundred-eleven cases of uterine rupture were compared to 607 controls. When accounting for length of labor, the risk of uterine rupture in induced labor was similar to spontaneous-onset labor (hazard ratio (HR) 1.52, 95% confidence interval (CI) 0.97-2.36). An initial unfavorable cervical exam was associated with an increased risk of uterine rupture compared to spontaneous (HR 4.09, 95% CI 1.82-9.17). Conclusion After accounting for labor duration, induction is not associated with an increased risk of uterine rupture in women undergoing TOLAC.

Harper, Lorie M.; Cahill, Alison G.; Boslaugh, Sarah; Odibo, Anthony O.; Stamilio, David M.; Roehl, Kimberly A.; Macones, George A.

2011-01-01

345

Cervical Cancer  

Science.gov (United States)

... by an infection of the cervix, including a yeast infection, infection with the human papillomavirus (HPV), the herpes virus, or many other infections. Abnormal cells. These changes are called cervical dysplasia. The cells are not cancer cells, but may be precancerous (which means they ...

346

Limitations of CT and ultrasound diagnoses in the evaluation of uterine cancer involvement  

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The concordance rates between preoperative diagnostic imagings and postoperative pathologic findings were examined in a total of 36 patients with resectable uterine cancer (19 with cervical cancer and 27 with endometrial cancer). The accuracy of CT was 47 % in the evaluation of cervical cancer involvement to the parametrium; and was 83 % in the evaluation of wall involvement of endometrial cancer. The concordance rate was 74 % in the evaluation of stage-grouping in endometrial cancer. Out of 8 patients with resectable stage II cervical cancer, four (50 %) were found to have had involvement to the parametrium by transrectal echography. The results indicate that CT scanning and transrectal echography have limitations in the diagnosis of cervical cancer involvement to the parametrium. (Namekawa, K.).

Sato, Yasumi; Maki, Masahiro; Seki, Haruo; Saito, Yoshiharu.

1988-07-01

347

Genome-wide association study of HPV-associated cervical cancer in Japanese women.  

Science.gov (United States)

One of the important factors influencing the development of uterine cervical cancer is human papillomavirus infection in women. Usually, the infecting papillomavirus is eliminated from individuals; however, some retain the virus and this is believed to lead to the development of uterine cervical cancer. It is possible that virus elimination or persistent infection depends on an individual's genetic background. To identify single nucleotide polymorphisms associated with susceptibility to persistent infection or cervical cancer, a genome-wide association study was performed on 226 cases and 186 controls. Some of the single nucleotide polymorphisms showed a P-value?cervical cancer were identified. J. Med. Virol. 86:1153-1158, 2014. © 2014 Wiley Periodicals, Inc. PMID:24700089

Miura, Kiyonori; Mishima, Hiroyuki; Kinoshita, Akira; Hayashida, Chisa; Abe, Shuhei; Tokunaga, Katsushi; Masuzaki, Hideaki; Yoshiura, Koh-Ichiro

2014-07-01

348

Magnetic resonance imaging of endometrial and cervical cancer.  

Science.gov (United States)

In this article we review the current and developing roles of magnetic resonance imaging (MRI) in endometrial and cervical cancer. In endometrial cancer, the purpose of MRI is to stage the primary tumor and in particular to identify myometrial and cervical invasion and extra-uterine disease, thereby informing preoperative surgical planning. MRI is also used to safely select young patients suitable for fertility-preserving medical management. In cervical cancer, MRI has an established role in local staging and in assessing proximal extension of tumors in young women for feasibility of fertility-preserving surgery. It is used to plan radiotherapy for primary tumors in cervical cancer and particularly for conformal radiotherapy to deliver optimal doses to the tumor sites, while limiting unwanted exposure of bowel and other pelvic organs. In both cancers, MRI is used for diagnosing nodal disease, surveillance, detection of recurrence, and evaluation of complications secondary to treatment. PMID:18837902

Sahdev, Anju; Reznek, Rodney H

2008-09-01

349

Characterization of the global profile of genes expressed in cervical epithelium by Serial Analysis of Gene Expression (SAGE  

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Full Text Available Abstract Background Serial Analysis of Gene Expression (SAGE is a new technique that allows a detailed and profound quantitative and qualitative knowledge of gene expression profile, without previous knowledge of sequence of analyzed genes. We carried out a modification of SAGE methodology (microSAGE, useful for the analysis of limited quantities of tissue samples, on normal human cervical tissue obtained from a donor without histopathological lesions. Cervical epithelium is constituted mainly by cervical keratinocytes which are the targets of human papilloma virus (HPV, where persistent HPV infection of cervical epithelium is associated with an increase risk for developing cervical carcinomas (CC. Results We report here a transcriptome analysis of cervical tissue by SAGE, derived from 30,418 sequenced tags that provide a wealth of information about the gene products involved in normal cervical epithelium physiology, as well as genes not previously found in uterine cervix tissue involved in the process of epidermal differentiation. Conclusion This first comprehensive and profound analysis of uterine cervix transcriptome, should be useful for the identification of genes involved in normal cervix uterine function, and candidate genes associated with cervical carcinoma.

Piña-Sanchez Patricia

2005-09-01

350

Congenital uterine malformations.  

Science.gov (United States)

With the advent of newer imaging techniques, the radiologist is now able to make very precise and accurate diagnoses of congenital uterine malformations and their complications. Because these anomalies are associated with reproductive dysfunction, they are often discovered during an infertility evaluation. By imaging parallel to the long axis of the uterus, the external contour can be evaluated, obviating laparoscopy for differentiating septate from bicornuate uteri. Obstructed uterovaginal anomalies (e.g., hematometros, hematometrocolpos), an important complication of abnormal müllerian duct development, can occur at any time from the newborn period to adulthood. Determining the site of obstruction is imperative for planning the proper surgical approach. To understand these malformations better, we review the relevant embryology. The most widely accepted classification scheme is discussed in detail, with an emphasis on diagnosis, prognosis, and therapeutic options. PMID:8536487

Woodward, P J; Sohaey, R; Wagner, B J

1995-01-01

351

Effects of Fermented Mushroom of Cordyceps sinensis, Rich in Selenium, on Uterine Cervix Cancer.  

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The purpose of this study was to investigate the effect of fermented mushroom of Cordyceps sinensis (CS), rich in selenium (Se-CS), on uterine cervical cancer in mice. The methylcholanthrene- (MCA-) induced tumor model was used in this paper. After the mice were administered Se-CS, the animals showed 40% tumor incidence (P < 0.05). Se-CS also enhanced the immune functions. Se-CS treatment showed significant (P < 0.05-0.01) restoration in the level of glutathione content, lipid peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na(+)/K(+)-ATPase activity, and glutathione S transferase activity. This finding suggested that the concomitant use of Se and CS could be a potential therapeutic approach to improve the efficacy of therapy for uterine cervical cancer. PMID:24971145

Ji, Jing; Liu, Juan; Liu, Haijuan; Wang, Yueling

2014-01-01

352

Effects of Fermented Mushroom of Cordyceps sinensis, Rich in Selenium, on Uterine Cervix Cancer  

Science.gov (United States)

The purpose of this study was to investigate the effect of fermented mushroom of Cordyceps sinensis (CS), rich in selenium (Se-CS), on uterine cervical cancer in mice. The methylcholanthrene- (MCA-) induced tumor model was used in this paper. After the mice were administered Se-CS, the animals showed 40% tumor incidence (P < 0.05). Se-CS also enhanced the immune functions. Se-CS treatment showed significant (P < 0.05–0.01) restoration in the level of glutathione content, lipid peroxidation, glutathione peroxidase activity, glutathione reductase activity, catalase activity, Na+/K+-ATPase activity, and glutathione S transferase activity. This finding suggested that the concomitant use of Se and CS could be a potential therapeutic approach to improve the efficacy of therapy for uterine cervical cancer.

Ji, Jing; Liu, Juan; Liu, Haijuan; Wang, Yueling

2014-01-01

353

Effects of the preoperative irradiation using small sourses for cervical cancer  

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Twenty four cases of cervical cancer received preoperative irradiation of a total of either 3,000 mgh, 4,500 mgh, and 6,000 mgh using small sourses. Large sections of the excected uterine, were prepared and isodose curves in the neighbourhood of the sourse were drown using glass dosimeter and water phantom. These lines were superimposed on large sections thereby, cervical tissue was examined histopathologically by various stages of absorbed dose. (Mukohata, S.)

1975-01-01

354

Correlation of apoptosis with tumour cell differentiation, progression, and HPV infection in cervical carcinoma.  

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AIMS: To clarify the significance of apoptosis in the progression of uterine cervical neoplasias, including cervical intraepithelial neoplasia (CIN), microinvasive carcinoma (MIC), and invasive squamous cell carcinoma (ISCC) categories, in relation to cell proliferation and human papilloma virus (HPV) infection. METHODS: Forty six cases of CIN I/II, 75 of CIN III, 16 of MIC, and 44 of ISCC were examined using formalin fixed and paraffin wax embedded samples. The TdT mediated dUTP-biotin nick ...

Shoji, Y.; Saegusa, M.; Takano, Y.; Ohbu, M.; Okayasu, I.

1996-01-01

355

Screening for Cervical Cancer  

Science.gov (United States)

... they might mean for you. What is cervical cancer? Cervical cancer is cancer that occurs in the cervix. ... to Know About™ Cancer of the Cervix (National Cancer Institute) Cervical Cancer (Centers for Disease Control and Prevention)

356

Cervical MRI scan  

Science.gov (United States)

... disc (cervical radiculopathy) Narrowing of the cervical spine ( spinal stenosis ) Abnormal wear of the bones and cartilage in the neck ( cervical spondylosis ) Abnormal results may also be due to: ... Spinal cord injury or compression Spinal fracture Spinal tumor ...

357

Get Tested for Cervical Cancer  

Science.gov (United States)

... uterus, ovaries, and other organs. What is cervical cancer? Cervical cancer is cancer of the cervix, which is ... womb) to the vagina. Learn more about cervical cancer and screening: Cervical Cancer [PDF - 897 KB] Cervical Cancer Screening Take ...

358

Bony Calvarium as the Sole Site ofMetastases in Squamous Cell Carcinomaof the Uterine Cervix  

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Full Text Available Isolated skeletal metastasis to the bony calvarium is extremely rare in patients with squamous cell carcinoma of the uterine cervix. We describe the clinical and imaging findings in a case of squamous cell carcinoma of the uterine cervix with metastases tothe bony calvarium as the sole site of metastasis. The patient was a 65-year-old woman with squamous cell carcinoma of the uterine cervix, FIGO stage IIIb, whose initial treatement was chemoradiation therapy. After 22 sessions of external-beam radiation,she developed headaches. On physical examination she had skull bone tenderness. On plain skull X-ray, there were osteolytic bony lesions. Brain MRI showed multiple enhancing skull bone metatstses. Eventually, a whole body bone scintigraphy revealed isolated diffuse increased activity in the bony calvarium. In the literature review, wefound only three similar cases of cervical cancer with scalp metastases and involvement of the bony calvarium.

Mohammad Mohammadianpanah

2010-10-01

359

A novel 'uterine sandwich' for haemorrhage at caesarean section for placenta praevia.  

Science.gov (United States)

Although massive haemorrhage at caesarean section (CS) for placenta praevia is a serious concern, effective treatment is not yet determined. We performed a new uterine sandwich to achieve haemostasis at CS for total placenta praevia in five consecutive cases in whom the placenta reached up to >5 cm from the internal cervical os in all directions of an uterine wall. A Matsubara-Yano (MY) uterine compression suture was placed, followed by placement of an intrauterine balloon. Haemostasis was achieved in all five cases with median blood loss of 1618 mL. No short-term adverse events were observed. The MY sandwich can be used to achieve haemostasis at CS for placenta praevia. PMID:24506478

Matsubara, Shigeki; Kuwata, Tomoyuki; Baba, Yosuke; Usui, Rie; Suzuki, Hirotada; Takahashi, Hironori; Ohkuchi, Akihide; Suzuki, Mitsuaki

2014-06-01

360

Soil Erosion Studies  

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Soil erosion affects a large part of the Earth surface, and accelerated soil erosion is recognized as one of the main soil threats, compromising soil productive and protective functions. The land management in areas affected by soil erosion is a relevant issue for landscape and ecosystems preservation. In this book we collected a series of papers on erosion, not focusing on agronomic implications, but on a variety of other relevant aspects of the erosion phenomena. The book is divided into th...

Godone, Danilo Francesco; Stanchi, Silvia

2011-01-01

 
 
 
 
361

Medical Treatment of Uterine Leiomyoma  

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Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to ...