ABSTRACT
OBJECTIVE: Reports on the repeated administration of medroxyprogesterone acetate (MPA) for intrauterine recurrence after fertility-preserving therapy for atypical endometrial hyperplasia (AEH) and early grade 1 endometrioid carcinoma (G1) are lacking. We aimed to clarify the outcomes of repeated MPA therapy in cases of intrauterine recurrence after fertility-preserving therapy with MPA against AEH/early G1. METHODS: Patients with AEH or stage IA well-differentiated endometrioid carcinoma without myometrial invasion who underwent first-line MPA therapy for primary lesions or intrauterine recurrence were divided into initial treatment and repeated treatment groups (162 and 82 patients, respectively). Oral MPA administration (400−600 mg/day) was continued until pathological tumor disappearance. Data regarding clinicopathological factors, adverse events, and outcomes following the initial and repeated hormonal treatments were extracted from medical records and analyzed. RESULTS: Complete response rates in the initial and repeated treatment groups were 98.5% and 96.4%, respectively, among patients with AEH, and were 90.7% and 98.1%, respectively, among patients with G1. In the initial treatment group, 5-year recurrence-free survival (RFS) rates were 53.7% and 33.2% among patients with AEH and G1, respectively. In the repeated treatment group, RFS rates were 14.0% and 11.2% among patients with AEH and G1, respectively. Among patients with AEH, the pregnancy rate tended to be lower in the repeated treatment group than in the initial treatment group (11.1% vs. 29.2%; p=0.107), while no significant group difference was observed among patients with G1 (20.8% vs. 22.7%). CONCLUSION: Repeated treatment is sufficiently effective for intrauterine recurrence after hormonal therapy for AEH/early G1.
Subject(s)
Female , Humans , Carcinoma, Endometrioid , Endometrial Hyperplasia , Endometrial Neoplasms , Fertility Preservation , Fertility , Hormone Replacement Therapy , Medical Records , Medroxyprogesterone Acetate , Medroxyprogesterone , Pregnancy Rate , RecurrenceABSTRACT
The purpose of this study was to investigate the effect of individual feedback intervention (IFB) or general video intervention (GV) on promoting daily physical activity. One hundred and thirty-six community-dwelling people volunteered as subjects and participated in the 2-month walking program provided as a correspondence course. The subjects were randomly allocated to one of four groups, which consisted of either IFB or GV. Each of the groups was based on behavioral science. The stage of change in exercise, self-efficacy for exercise and daily physical activity were measured before and after intervention 4 months later during the follow-up period. There were statistically significant effects of both ‘time’ (F=3.71, p=0.026) and ‘time’בIFB’ (F=3.76, p=0.025) in self-efficacy for exercise; while there was no significant effect of interaction between ‘time’בGV’. As for daily physical activity, there was no significant effect of the interaction both of ‘time’בIFB’ and ‘time’בGV’. These results suggest the IFB of promoting self-efficacy for exercise.
ABSTRACT
This study was designed to investigate the effects of supplementing soy peptide on isometric performances and serum CK and LDH trends after a high intensity eccentric exercise stress. Study subjects consisted of 13 males and were divided into 2 groups. They were instructed to take 4,000 mg of soy peptide or placebo orally before and for 7 days following the initial exercise stress. Soy peptide group revealed significantly faster improvements in knee extension performance at 72 hr-post the eccentric exercise (p<0.05). Comparing with placebo group, soy peptide group showed significantly lower serum LDH activity 168 hr after the exercise (p<0.05), while as to serum CK levels, significant difference was not observed between those 2 groups. These results indicate that oral supplementation of soy peptide could induce not only reduction in serum LDH activity level, but also faster recovering in isometric performance after high intensity repetitive eccentric exercise.
ABSTRACT
<b><i>Background</i></b> A behavioral science-based approach is essential for constructing effective intervention programs to promote the shift from a sedentary to active lifestyle. Recently, the influences of social and physical environment on physical activity have been recognized as key factors for promoting physical activity. The present study attempts to identify the social and physical environmental influences associated with physical activity promotion.<b><i>Methods</i></b> We recruited volunteers from a 14,000 population of community-dwelling adults. Seventy-two adults (intervention group : n=35, control group : n=37) participated in the present study. The intervention consisted of 8 sessions for 2 months using <i>The Waseda Walking Program</i>. We assessed social support for exercise, perceived neighborhood environment for walking, stages of change in exercise behavior and physical activity outcomes at baseline and 2 months. Ffifty-seven out of 72 subjects (intervention : n=30, control : n=27) completed all of the intervention including the final questionnaire.<b><i>Results</i></b> There were significant intervention effects on physical activity outcomes, stages of change and perceived neighborhood environment. However, no significant improvement in social support was found. In addition, improvement of perceived physical environment was related to an increase in physical activity.<b><i>Conclusion</i></b> Perceived neighborhood environment for walking would be identified as a key factor to influence an effect of physical activity promotion. On the other hand, social support would be influenced to the earlier stages of change in exercise.