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Objective: To analyze the outcomes of sequential or sandwich chemotherapy (ChT) and radiotherapy (RT) in patients with node-positive endometrial cancer (EC). Methods: Data from 4 centers were collected retrospectively for 179 patients with stage IIIC EC treated with postoperative RT and ChT (paclitaxel and carboplatin). Patients were either treated with 6 cycles of ChT followed by RT (sequential arm; 96 patients) or with 3 cycles of ChT, RT, and an additional 3 cycles of ChT (sandwich arm; 83 patients). Prognostic factors affecting overall survival (OS) and progression-free survival (PFS) were analyzed. Results: The 5-year OS and PFS rates were 64% and 59%, respectively, with a median followup of 41 months (range, 5–167 months). The 5-year OS rates were significantly higher in the sandwich than sequential arms (74% vs. 56%; p=0.03) and the difference for 5-year PFS rates was nearly significant (65% vs. 54%; p=0.05). In univariate analysis, treatment strategy, age, International Federation of Gynecology and Obstetrics (FIGO) stage, pathology, rate of myometrial invasion, and grade were prognostic factors for OS and PFS. In multivariate analysis, non-endometrioid histology, advanced FIGO stage, and adjuvant sequential ChT and RT were negative predictors for OS, whereas only non-endometrioid histology was a prognostic factor for PFS. Conclusion: Postoperative adjuvant ChT and RT for stage IIIC EC patients, either given sequentially or sandwiched, offers excellent clinical efficacy and acceptably low toxicity. Our data support the superiority of the sandwich regimen compared to the sequential strategy in stage IIIC EC patients for OS.
The paper studies the effects of expansionary fiscal policy in a general equilibrium model of a small open economy with a recursive time preference structure in which the intertemporal optimizing behavior of infinitely-lived agents endogenously determines employment, investment, and the current account. It is shown that the adjustment to the steady state may be cyclical and the long-run government spending multiplier may exceed one.
In this report, we describe a case of endometrial carcinoma arising in one horn of a bicornuate uterus. The diagnosis of this rare combination can be missed unless an unrecognized postmenopausal bleeding alerts the gynecologist to make a careful search for both endometrial cavities that may be curetted. Physicians should remember the possible existence of a separate uterine cavity when endometrial cancer is clinically suspected but histology fails to confirm the diagnosis. In this report, we describe a case of endometrial carcinoma arising in one horn of a bicornuate uterus. The diagnosis of this rare combination can be missed unless an unrecognized postmenopausal bleeding alerts the gynecologist to make a careful search for both endometrial cavities that may be curetted. Physicians should remember the possible existence of a separate uterine cavity when endometrial cancer is clinically suspected but histology fails to confirm the diagnosis.
The web-based portfolio emerged as a result of the influence of technological developments on educational practices. In this study, the effect of the web-based portfolio building process on academic achievement and retention is explored. For this purpose, a study platform known as a computer-assisted personal development portfolio was designed for 30 Turkish students who participated in a web-based portfolio process. The academic achievements of the students were examined through an experimental design in which participants were divided into an experimental group and a control group and given a pre-test and a post-test. The results of the study revealed that the levels of both academic achievement and retention in the experimental group were significantly higher than those in the control group. Similar practices can be applied to the teaching of medicine, economics, physical sciences, humanities and other subjects in order to extend students' performance and achievement levels.
Purpose: This study aimed to determine the effects of the long-term use of dehydroepiandrosterone sulfate (DHEAS) on rat prostates and testes as well as on serum testosterone and DHEAS levels. Materials and Methods: Thirty male rats aged 4 to 5 months were studied. A DHEAS suspension of 5 mg/kg per rat was administered orally to the 15 rats in the experimental group 5 times a week, whereas saline was administered concurrently to the 15 rats in the control group. Intracardiac blood samples were drawn to determine hormone levels,and histological samples of prostate and testes were evaluated under light microscopy. Results: At the end of the 6-month study period, histological examinations performed on prostate preparations showed that the atrophy score of the experimental group was significantly lower than the scores of the sham and control groups (p<0.001 and p <0.001, respectively). The serum total testosterone and DHEAS levels of the rats in the study group were significantly increased (p<0.001). Conclusions: In our study, we determined that the long-term use of DHEAS does not have any detrimental effects on the prostate or the testis; on the contrary, it protects the prostate from atrophy, which is imperative for the continuation of fertility as well as for increasing serum testosterone and DHEAS levels.
Cem,Yucel,Fatma,Demet,Arslan,Sumeyye,Ekmekci,Volkan,Ulker,Erdem,Kisa,Elcin,Erdogan,Yucel,Murat,Ucar,Yusuf,Ozlem,Ilbey,Orcun,Celik,Banu,Isbilen,Basok,Zafer,Kozacioglu 대한남성과학회 2019 The World Journal of Men's Health Vol.37 No.2
Purpose: To investigate the effects of all-trans retinoic acid (ATRA) in cisplatin (CP)-induced testicular damage in rats. Materials and Methods: Twenty-eight male Wistar rats were divided into four groups: Control, ATRA alone, ATRA+CP, and CP alone. Body weight, testicular weight, sperm count, sperm motility, percentage of abnormal sperm, total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI) in testicular tissue, and testicular histopathology were compared among groups. Results: The sperm count and motility significantly decreased and the percentage of abnormal sperm significantly increased in the CP group compared to the control and ATRA groups. CP+ATRA administration significantly increased the sperm count and motility, but reduced the abnormal sperm count. CP administration significantly increased TOS and OSI compared to the control group and the other groups. Administering CP+ATRA significantly decreased TOS and the OSI in testicular tissue and reduced spermatogenesis, but increased the Johnsen score. Conclusions: The destructive effects of CP treatment on testicular tissue and spermatogenesis were reduced by administering ATRA.
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Attention deficit hyperactivity disorder (ADHD) is a life-long neurodevelopmental disorder and treatment depends on pharmacotherapy because of its biological origin. Stimulant drugs are the most commonly used treatment for ADHD and they have various side effects. Herein, we report a case who bit off the tip of her tongue with Osmotic Release Oral System methylphenidate (OROS MPH) 36 mg/day, bit the tip of her lower lip with immediate release (IR) MPH 10 mg/day and lateral part of her tongue with IR MPH 20 mg/day. A diagnosis of epilepsy was unlikely because of the normal neurological examination and electroencephalography findings. This case was considered as an atypical side effect of MPH such as perseverative/compulsive behaviours and movement disorders. Clinicians should be aware of that stimulant medications may cause lip and tongue biting behavior and this may effect treatment compliance tremendously.
A study has been undertaken to evaluate the similarities and differences between the steel building design specifications used in the United States and Europe. Expressions for nominal strength presented in the AISC-360 Specification and the Eurocode 3 Specification were compared for fundamental limit states. In particular, rules for cross-section classification, tension members,compression members, I-shaped members subjected to flexure, I-shaped members subjected to shear, and fasteners were studied. Results of the investigation revealed that, in general, both specifications provide nominal capacities that are close to each other. Significant differences were reported for some limit states such as flexure in I-shaped members with non-compact flanges, shear and lateral torsional buckling in I-shaped members, and bearing strength at bolt holes. In this paper, the details of the comparative study are presented along with observations that are useful for practicing engineers
Lumbar disc herniation is characterized with low back and leg pain resulting from the degenerated lumbar disc compressing the spinal nerve root. The etiology of degenerative spine is related to age, smoking, microtrauma, obesity, disorders of familial collagen structure, occupational and sports-related physical activity. However, disc herniations induced by congenital lumbar vertebral anomalies are rarely seen. Vertebral fusion defect is one of the causes of congenital anomalies. The pathogenesis of embryological corpus vertebral fusion anomaly is not fully known. In this paper, a 30- year-old patient who had the complaints of low back and right leg pain after falling from a height is presented. She had right L5-S1 disc herniation that had developed on the basis of S1 vertebra corpus fusion anomaly in Lumbar computed tomography. This case has been discussed in the light of literature based on evaluations of Lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). This case is unique in that it is the first case with development of lumbar disc herniation associated with S1 vertebral corpus fusion anomaly. Congenital malformations with unusual clinical presentation after trauma shouldbe evaluated through advanced radiological imaging techniques.