Effect of arsenic trioxide maintenance therapy on long - term recurrence rate in patients with acute promyelocytic leukemia / 中国基层医药

Objective To explore the effect of arsenic trioxide maintenance therapy on the long-term recur-rence rate in patients with acute promyelocytic leukemia ( APL ) . Methods From December 2011 to December 2013,60 patients with APL in the First People's Hospital of Huzhou were selected and divided into control group and observation group according to random number table, with 30 cases in each group. All patients received the same induction therapy and consolidation therapy. During the maintenance treatment period, all - trans retinoic acid ( ATRA) was given to the control group,and arsenic trioxide was used in the observation group. The serum levels and incidence of adverse reactions in the two groups were detected and compared after two cycles of the maintenance therapy. Three years of follow - up was conducted after treatment to record and compare the recurrence rate and survival rate in the two groups. Results The levels of TC and TG after 1 and 2 cycles of treatment were higher than those before treatment in both two groups(all P<0. 05),but the levels of lipid indicators in the observation group were lower than those in the control group,and the differences were statistically significant (t=2. 044,2. 175,all P<0. 05). The incidence rates of retinoic acid syndrome,elevated intracranial pressure and other adverse reactions in the observation group during the treatment were lower than those in the control group(6. 67％ vs. 26. 67％,6. 67％ vs. 30. 00％,6. 67％ vs. 26. 67％),and the differences were statistically significant(χ2 =0. 043,0. 023,0. 043,all P<0. 05). The survival rates after 2 and 3 years of treatment in the observation group were higher than those in the control group(90. 00％ vs. 66. 67％,83. 33％ vs. 60. 00％),and the differences were statistically significant(χ2 =4. 812,4. 812,all P<0. 05). The recurrence rate after 3 years of treatment in the observation group was lower than that in the control group(10. 00％ vs. 33. 33％),and the difference was statistically significant(χ2 =4. 812,P <0. 05). Conclusion For patients with APL, the application of arsenic trioxide in the maintenance therapy can produce no significant effect on their lipid metabolism, and at a certain extent, can help reduce the incidence of adverse reactions and recurrence rate,and improve the survival rate.

Analysis on relevant factors of cervical intraepithelial neoplasia residual or recurrence after loop electrosurgical excision procedure / 重庆医学

Objective To analyze relevant factors of cervical intraepithelial neoplasia residual or recurrence after loop electri‐cal excision procedure(LEEP) .Methods We observed the patients who were histopathologically confirmed CIN and treated with LEEP in our hospital from January 2006 to September 2012 ,and investigated the postoperative residual and recurrence .Then we an‐alysed relevant factors of residual or recurrence .Results (1)After at least 2 years of follow‐up ,26 cases showed residual or recur‐rence(the residual rate was 0 .97% and the recurrence rate was 4 .08% ) .(2)Overall severity of residual or recurrence had been re‐duced ,but the severity and recurrence of preoperative severity was positively correlated(r=0 .354 0 ,P<0 .05) .(3)Age ,smoking , preoperative high‐risk HPV load ,post‐operative the same type of HPV continuous infection ,endocervical involvement ,lesions in‐vo1ving quadrants ,and post‐operative TCT results between the recurrence group and non‐recurrence group were statistically signifi‐cant different(P<0 .05) .Conclusion CIN residual or recurrence after LEEP might be affected by many factors ,and the treatment should be individualized .

Clinical Outcome of Parosteal Osteosarcoma / 대한골관절종양학회지

PURPOSE: The purpose of this study was to evaluate the oncologic outcomes of parosteal osteosarcoma (POS) and to ascertain the fates of patients after local recurrence (LR). MATERIALS AND METHODS: The authors retrospectively reviewed 22 POS patients with an average follow-up of 114 months (range: 36-235 months). Seven of the 22 patients were referred after LR. There were 17 Stage IB and 5 Stage IIB (G2, 2; dedifferentiation, 3). Tumors were located in the femur (11) and in other locations (11). Initial surgical margins were wide in 10, marginal in 5, and intralesional in 7. Correlations between clinico-pathologic variables and LR and clinical courses after LR were evaluated. RESULTS: The 10-year overall survival rate was 85.7%. Three (14%) patients developed distant metastasis and all of them succumbed to the disease. Nine (41%) patients developed LR. Tumor location, resection type, and surgical margin were found to be correlated with LR. At final follow-up, 7 of the 9 patients that experienced local failure achieved no evidence of disease. CONCLUSION: A substantial risk of misdiagnosis exists, especially for POS in other than a femoral location. Recurrent tumor re-excision is possible in most cases; however, patients with an aggressive recurrence pattern deserve special attention.

Efficacy and safety of L-asparaginasum plus DICE regimen in the treatment of relapsed and refractory non-Hodgkin's lymphoma / 白血病·淋巴瘤

Objective To observe the efficacy and adverse events of L-asparaginasum plus DICE regimen in the treatment of relapsed and refractory non-Hodgkin's lymphoma (NHL). Methods Thirty-one patients with relapsed and refractory NHL were treated with L-asparaginasum plus DICE regimen. Each patient was scheduled to receive 2 to 6 cycles.Results Among the 31 assessable patients,11 (35.5 ％) achieved a complete remission (CR),14(45.2 ％) got a partial remission (PR),2 were stable,4 were progressive.The overall response (CR + PR) rate was 80.7 ％.The median survival was 8 months (rang:2-38 months).The 1-year survival rate was 43.3 ％,the 2-year survival rate was 32.5 ％.The main adverse events were myelosuppression,digestive tract reaction,allergy and edema.No treatment-related death was observed.Conclusion The L-asparaginasum plus DICE regimen is effective and safe for the relapsed and refractory NHL.

A Patient with Distinct Evidences of Spontaneous Regression and Recurrence of Gastric Cancer for 13 Years

Spontaneous regression (SR) of malignancy is a rare phenomenon, especially in patients with gastric cancer. A 77-year-old male, who was already diagnosed with gastric adenocarcinoma by endoscopic biopsy from a private clinic, was referred to our hospital. Despite our strong recommendation, the patient refused surgical therapy. A follow-up endoscopy was performed 3 months later, which revealed that the ulcer had changed into a white scar. Endoscopic biopsy revealed only chronic inflammation. Two and 6 years later, cancer recurred, and SR was confirmed both times, histologically, at the gastric body. The patient is still alive without any gastrointestinal symptoms after 13 years of follow-up. The cause of SR is yet uncertain and there are only a few suggestions of scientific mechanisms. We, herein, report this very rare case of repeated recurrence and SR of gastric cancer without clear cause.

Intersphincteric Resection versus Stapled Coloanal Anastomosis for Low Rectal Cancer

PURPOSE: Local control and functional results of an intersphincteric resection are controversial in Asian, low BMI patients, even though it might a provide a chance to avoid a permanent colostomy. We tried to evaluate the potential risk of an intersphincteric resection, compared with a stapled coloanal anastomosis, in patients with low rectal cancer. METHODS: Patients with low rectal cancer, who underwent a intersphincteric resection with a hand-sewn anastomosis (ISR) or a coloanal anstomosis with staples (stapled CAA), were analyzed. RESULTS: From 1999 to 2006, 85 patients were enrolled. The distance between the anal verge and the lower margin of the tumor was 3.4+/-0.8 cm (range: 2~5 cm) in the ISR group and 4.9+/-0.8 cm (range: 3~7 cm) in the stapled CAA. The mean body mass index was 23 (range: 18~32). The patients complained postoperatively of intolerable anal incontinence (Kirwan's class > 2) in 35% of the ISR group and in 9% as the stapled CAA group, (P<0.02). The local recurrence rate was greater in the ISR group (15%) than in the stapled CAA group (2%, P<0.04). There was no significant difference in distant metastasis between the two groups. The disease-free survival rates were 80.8% and 91.2% at three years in the ISR group and the stapled CAA group, respectively. Complications, such as urinary incontinence and sexual dysfunction in male patients, were not significantly different between the two groups. CONCLUSIONS: An intersphincteric resection with hand-sewn anastomosis could be worse than a stapled coloanal anastomosis in function and local recurrence. This may indicate that careful selection is required for a intersphincteric resection even when a stapled anastomosis cannot be applied due to a narrow margin.

The clinical experience of recurred urinary stone / 中国基层医药

Objective To summarize the clinical experience of treatment of recurred urinary stone.Methods The patients who needed to be treated again from 1998 to 2002 were reviewed.Results Patients with recurred urinary stone were differentiated by symptom,the causation of recurred stone and operation.Conclusion The pointed step must be adopted based on the clinical character of recurred urinary stone.Preventing against recurred and choosing appropriate method can improve the treatment effect.

The value of sentinel node HPV status for prediction of lymphnode metastasis and recurrence in cervical cancer patients / 부인종양

OBJECTIVE: The "sentinel node" is defined as the first lymph node encountered by lymphatic vessels draining a tumor. We tried to examine whether pathologic status of sentinel nodes of cervical cancer patients represent metastatic status of pelvic and paraaortic lymph nodes and to investigate the correlation between sentinel node HPV status and lymph node metastasis and recurrence of cervical cancer patients. METHODS: From August 2001 to December 2003, 57 patients affected by stage IB-IIA cervical cancer had sentinel node biopsies performed during radical hysterectomy and pelvic and paraaortic lymphadenectomy. We performed sentinel lymph node pathologic examination by frozen section and HPV typing by oligonucleotide microarray. After two years of follow up, we analyzed the prognosis of patients. RESULTS: Sentinel nodes were identified in all of our patients. A total of 79 nodes were detected as sentinel nodes. Metastasis in the sentinel nodes were found in 10 patients by frozen section and 11 patients by permanent pathologic examination. The results of sentinel lymph node frozen biopsy were statistically significant for predicting the metastatic status of the pelvic lymph nodes (p<0.05), but showed one false negative case. HPV DNA was detected in the cervices of 55 patients (96.5%), 44 (80.0%) of whom were found to have HPV DNA in the sentinel nodes. HPV DNA was detected in sentinel nodes of 10 patients among 11 patients with lymph node metastases. After mean follow up of 31.7 months (range; 1-48), disease recurred in five patients and all of these patients showed HPV in sentinel nodes. Combination of sentinel node frozen biopsy and HPV typing showed negative predictive value of 100% in predicting lymph node metastasis and recurrence. CONCLUSION: Our result suggests the possibility that sentinel node HPV typing would play a supportive role to reduce false negative rate of sentinel node biopsy. Additional study will be needed to confirm the clinical application of sentinel lymph procedure and to reveal correlation between HPV status of sentinel nodes and lymph node metastasis and recurrence of cervical cancer patients.

Early Results of Subcutaneous Mastectomy with Immediate Breast Reconstruction as a Treatment for Early Breast Cancer

PURPOSE: Subcutaneous mastectomy, combined with immediate breast reconstruction has become popular for breast cancer management. This type of surgery allows for an improved cosmetic result. Although subcutaneous mastectomy is becoming more common, there is little data regarding the local recurrence (LR) rate after this procedure. METHODS: A total of 93 patients were treated for breast cancer by subcutaneous mastectomy with immediate breast reconstruction using permanent prosthesis at Yeungnam University Hospital from September 1996 to April 2003. The inclusion criteria for this procedure were peripherally located tumor, a tumor size smaller than T2, clinically negative axillary lymph node, and a grossly normal nipple and areolar area. To avoid recurrence at the nipple-areolar complex (NAC), a frozen biopsy of the NAC resection margin was performed in all cases. RESULTS: The mean follow-up period was 26 months, and the mean age of the patients was 40.2 years. According to the American Joint Committee on Cancer staging, the stage was as follows: stage 0, 9 patients; stage I, 39 patients; and stage II, 45 patients. The overall LR rate was 5.4% (5 of 93 patients). The mean local relapse-free interval was 30 months. The sites of LR were at the peripheral breast tissue and at the NAC. Only one of 79 patients with preservation of the NAC developed LR at the NAC during the follow-up. LR at the NAC was low as 1.3%. No statistical differences in the LR rates were demonstrated between the NAC-spared group and the NAC-resected group (P>0.05). CONCLUSION: Subcutaneous mastectomy with immediate breast reconstruction using permanent prosthesis as a treatment for early breast cancer is a good treatment modality. Furthermore, preservation of the nipple-areolar complex increases the satisfaction of patients by improving the cosmetic result, and this procedure is both feasible and oncologically safe for breast cancer patients.

Amnion Transplant Combining Interferon aIb Dripping Eyes Can Prevent Recurrent Pterygium Excision After the Operation / 中国医师杂志

Objective Effect of preventing recurrent pterygium excision combining amnion transplant by using recombinate interferon aIb drip eyes. Methods 105 cases of pterygium excision and combining amnion transplant patients were divided two groups,one group was treated by interferon aIb dripping eyes for 50 pterygium, another group was treated by 0.1%fu mi long drip eyes liquid to drop eyes as a contrast group. Results 50 patients in treatment group were followed up a case by regular visits to months after the operation and none of them had not been seen pterygium recurrent after passing 12～24 months and average time was 15 months;55 patients in contrast group had 6 recurrents,recurring rate was 10.9%,the statistic difference was significant( P

A Case of Acquired Digital Fibrokeratoma / 대한피부과학회지

Acquired digital fibrokeratornas are uncommon, benign, acquired, firm, hyperkeratotic projectic projections, mostly arising at the finger, toe, and distal portion of extremity. We experienced a case of acquired digital fibrokeratoma arising the 4th tae in 37-year old male. Tumor mass was 2 X 1.5cm in size, round hyperkeratotic protruded mass. Histopathologically, the epidermis of the tumor showed compact hyperkeratosis, focal hypergranulosis, and irregular acanthosis. Thick collagen bundles and dilated capillaries were predominantly oriented in the direction of the longitudinal axis of the lesion. After simple excision was done, a new lesion appeared 2 months later.