PURPOSE: To describe chronic rectal mucosal damage after pelvic radiotherapy (RT) for cervical cancer and correlate these findings with clinical symptoms and radiation dose. MATERIALS AND METHODS: Thirty-two patients who underwent pelvic RT were diagnosed with radiation-induced proctitis based on endoscopy findings. The median follow-up period was 35 months after external beam radiotherapy (EBRT) and intracavitary radiotherapy (ICR). The Vienna Rectoscopy Score (VRS) was used to describe the endoscopic findings and compared to the European Organization for Research and Treatment of Cancer (EORTC)/Radiation Therapy Oncology Group (RTOG) morbidity score and the dosimetric parameters of RT (the ratio of rectal dose calculated at the rectal point [RP] to the prescribed dose, biologically effective dose [BED] at the RP in the ICR and EBRT plans, alpha/beta = 3). RESULTS: Rectal symptoms were noted in 28 patients (rectal bleeding in 21 patients, bowel habit changes in 6, mucosal stools in 1), and 4 patients had no symptoms. Endoscopic findings included telangiectasia in 18 patients, congested mucosa in 20, ulceration in 5, and stricture in 1. The RP ratio, BEDICR, BEDICR+EBRT was significantly associated with the VRS (RP ratio, median 76.5%; BEDICR, median 37.1 Gy3; BEDICR+EBRT, median 102.5 Gy3; p < 0.001). The VRS was significantly associated with the EORTC/RTOG score (p = 0.038). CONCLUSION: The most prevalent endoscopic findings of RT-induced proctitis were telangiectasia and congested mucosa. The VRS was significantly associated with the EORTC/RTOG score and RP radiation dose.
Constriction, Pathologic ; Endoscopy ; Estrogens, Conjugated (USP) ; Follow-Up Studies ; Hemorrhage ; Humans ; Mucous Membrane ; Proctitis ; Radiation Injuries ; Rectum ; Telangiectasis ; Ulcer ; Uterine Cervical Neoplasms

No abstract available.
Adrenocorticotropic Hormone* ; Humans ; Infant ; Infant, Newborn ; Spasms, Infantile*

No abstract available.
Induction Chemotherapy* ; Uterine Cervical Neoplasms*

BACKGROUND: Herpes simplex virus thymidine kinase (HSVtk) phosphorylates the prodrug ganciclovir to a nucleoside analog that inhibits DNA synthesis, causing cell death. Neighbouring nontransfected cells may be affected through a 'bystander effect', thereby amplifying the antiproliferative actions. This study was carried out to determine whether retrovirus-mediated HSVtk gene therapy could reduce intimal hyperplasia and prevent stenosis following balloon injury of the rat carotid artery. METHODS: A replication-defective recombinant retroviral vector containing HSVtk cDNA (LtkSN) was constructed. Cultured primary rat smooth muscle cells (SMCs) infected with this vector (SMC/LtkSN) were transplanted to the balloon injured rat right carotid artery. One week after transplantation, HSVtk gene therapy group was administered a 2-week treatment of ganciclovir (30 mg/kg/d). Three weeks after balloon injury and SMC/LtkSN transplantation, carotid arteriography was performed and carotid arteries were perfusion-fixed for histologic examination. RESULTS: Carotid arteriographic evaluation comparing with the uninjured left carotid artery showed that the mean luminal diameter of HSVtk gene therapy group (n=5, 85+/-3%) was significantly larger than that of balloon injury only group (n=5, 65+/-5%). The neointimal mass of HSVtk gene therapy group was less than that of balloon injury only group. SMC/LtkSN transplantation without ganciclovir treatment group (n=3) showed asymmetric intimal proliferation probably because of gravitational pooling of seeding. There were inflammatory cell infiltrations at the gravity dependent portion of HSVtk gene therapy group. CONCLUSION: Retrovirus-mediated HSVtk gene therapy following balloon injury of the rat carotid artery reduced neointimal expansion and arteriographic stenosis.
Angiography ; Animals ; Carotid Arteries* ; Carotid Artery Injuries* ; Cell Death ; Constriction, Pathologic* ; DNA ; DNA, Complementary ; Ganciclovir ; Genetic Therapy* ; Gravitation ; Herpes Simplex* ; Hyperplasia ; Myocytes, Smooth Muscle ; Phenobarbital ; Phosphotransferases* ; Rats* ; Simplexvirus* ; Thymidine Kinase ; Zidovudine

BACKGROUND: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. METHODS: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. RESULTS: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. CONCLUSION: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
Angiography ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Blood Vessel Prosthesis* ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Polytetrafluoroethylene* ; Popliteal Artery* ; Stents* ; Transplants ; Veins

BACKGROUND: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. METHODS: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral–above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft. Ring-supported PTFE grafts were used in all patients with no available vein for graft material. Follow-up evaluations assessed clinical symptoms, the ankle-brachial index, ultrasonographic imaging and/or computed tomography angiography, the primary patency rate, and complications. RESULTS: All procedures were successful. The mean follow-up was 12.6 months (range, 11 to 14 months), and there were no major complications. The median baseline ankle-brachial index of 0.4 (range, 0.2 to 0.55) significantly increased to 0.8 (range, 0.5 to 1.0) at 12 months (p<0.01). The primary patency rate at 12 months was 83.3%. The presenting symptoms resolved within 2 weeks. CONCLUSION: In AK bypasses with a diffusely diseased distal target popliteal artery or when below-knee (BK) bypass surgery is impossible, this procedure could be clinically effective and safe when used as an alternative to femoral-BK bypass surgery.
Angiography ; Ankle Brachial Index ; Arterial Occlusive Diseases ; Arteries ; Blood Vessel Prosthesis* ; Extremities ; Follow-Up Studies ; Humans ; Ischemia ; Polytetrafluoroethylene* ; Popliteal Artery* ; Stents* ; Transplants ; Veins

Spindle cell hemangioendothelioma was first described in 1986 by Weiss and Enzinger as a low grade angiosarcoma resr mbling a cavernous hemangioma and kaposis sarcoma. Recently, it is suggested to be non neoplastic lesion or reactive process arising from pre-existing vascular mal- formation. We report a case of spindle cell hemangioendothelioma in a 9-month-old boy. He had multiple, variable sized, colorful, cutaneous or subcutaneous nodules on the forearm and hand. The tumor first appeared on the forearm as erythematous patches at birth and grew rapidly with- in 3 months. Histopatholgical findings showed that the lesion was composed of thin walled cavernous spaces mixed with spindle cells and occasional epithelioid endothelial cells containing intracytoplasmic vacuole. Most af the endothelial cells lining the cavernous spaces and intracytoplasmic lumina, were positive for factor VIII associated antigen. But the spindle cells were negative. Atypical vascular structures resembling arteriovenous shunts were noted around the tumor suggesting a reactive proliferation due to disturbance of local blood flow. Several turnors were excised. No recurrence has been recognized in the one year- follow-up period.
Endothelial Cells ; Factor VIII ; Follow-Up Studies ; Forearm ; Hand ; Hemangioendothelioma* ; Hemangioma, Cavernous ; Hemangiosarcoma ; Humans ; Infant ; Male ; Parturition ; Recurrence ; Sarcoma, Kaposi ; Vacuoles

The healthcare for elite athletes has the potential to create many ethical issues for sports practitioners. And the relationship between a sports practitioner and an athlete differs significantly from the traditional doctor-patient relationship. However, there has been little discussion of them to date. To investigate the ethical awareness and concerns in sports medicine field, we surveyed the responses of Korean medical team to a questionnaire during the Summer Olympic Games 2012. The questionnaire was developed to access a wide-range of common ethical issues in sports medicine; conflict of interests, confidentiality, pediatric athletes, performance-enhancing substances, infectious disease, innovative therapies, medical advertising. Twenty-nine out of 32 sports practitioners responded to the questionnaire (90.6%). Respondents identified many ethical matters concerning the unique characteristics of athletes-as-patients in sports medicine. This study has started the process of identifying contemporary ethical problems with regard to the sports medicine, and there should be further studies dealing with these problems.
Athletes ; Communicable Diseases ; Confidentiality ; Conflict of Interest ; Delivery of Health Care ; Humans ; Performance-Enhancing Substances ; Surveys and Questionnaires ; Sports ; Sports Medicine ; Therapies, Investigational

For effective prevention of doping, individual and situational factors that make an elite athlete more susceptible to doping than others should be investigated. The aim of this study was to quantitatively measure doping related attitudes and dispositions of adolescent competitive athletes at elite level. Data were collected by questionnaires among athletes (n=123) who were participating in the 2nd Asian Youth Games. Outcome measures included doping knowledge, behavior and attitude (performance enhancement attitude scale, PEAS). One athlete admitted the past use of doping and 2 athletes reported that they knew others who had doped. Athletes were mainly provided with anti-doping information from anti-doping agency (16.3%), coaches (11.4%) or medical staffs (10.6%). The average PEAS score was 38.39+/-11.36. High school (elder) athletes showed higher PEAS score (39.63+/-11.35) than middle school (younger) athletes (34.53+/-10.67) and team sport athletes showed lower PEAS score (35.11+/-9.80) than athletes in endurance (45.08+/-15.49) or motor skill sports (43.25+/-9.08). This study suggests that many factors play an important role in athlete's decisions regarding the use of doping. Further research should incorporate these factors to understand the complexity of doping and to identify points for effective anti-doping program.
Adolescent* ; Asian Continental Ancestry Group ; Athletes* ; Humans ; Medical Staff ; Motor Skills ; Outcome Assessment (Health Care) ; Peas ; Surveys and Questionnaires ; Sports

PURPOSE: A survey was performed to identify the level of mouthguard use, awareness, wearability issues and attitude toward mouthguard among elite Korean Taewondo athletes. MATERIALS AND METHODS: Survey questionnaires were given to 152 athletes participating in the Korea National Taekwondo team selection event for the 2010 Guangzhou Asian Games. Questionnaires consisted of three sections, mouthguard awareness, reasons for not wearing mouthguard and the last section to test the level of acceptance on current mouthguard and when the identified problems were resolved. For analyzing difference among response, chi2 test was used and significant level (alpha) was set up as 0.05. RESULTS: Responses in each of items showed significant difference (P<.001). Majority of response regarding each question: Majority of respondents believed that mouthguard were effective in preventing injuries (36.4%) but the result suggested that the provision of information on mouthguard to athletes was inadequate (44.0%) and the result showed that respondents were not greatly interested or concerned in relation to the mandatory mouthguard rule (31.6%). Although the responses on the level of comfort and wearability of mouthguard were negative (34.8%), athletes were positively willing to wear mouthguard if the problems rectified (51.2%). CONCLUSION: Considering the high level of willingness to wear mouthguard if the problems rectified, it is thought that together with efforts in providing more mouthguard information, the work of sports dentistry to research and improve mouthguard will be invaluable in promoting mouthguard to more athletes.
Asian Continental Ancestry Group ; Athletes ; Dentistry ; Humans ; Korea ; Martial Arts ; Mouth Protectors ; Sports ; Surveys and Questionnaires