To overview the status of gynecologic cancer in Indonesia. Information regarding Indonesia obtained from World Bank Report and Statistical Yearbook of Indonesia 2007, epidemiological data obtained from Histopathological Data of Cancer in Indonesia 2002, Department of Health-Registry Body of Indonesian Specialist of Pathology Association-Indonesian Cancer Society; Various Hospitals in big Cities in Indonesia. Indonesia is an Archipelago with a total area of 1,922,570.00 km2, the population is 222,192,000 (2006), the fourth world rank. Female is 49.86% with life expectancy 69 years. Gross National Product per Capita is 690.00 USD. Histopathological report in 2002 revealed that cervical cancer, ovarian cancer and uterine cancer were the most frequent cancer among female, which were the first (2,532 cases), the third (829 cases) and the eighth (316 cases) rank respectively. The peak age for cervical, uterine and ovarian cancer was 45-54 years. HPV 16, 18 were found in 82% of invasive cervical. Data from various academic hospitals in 2007 showed that cervical cancer is the most common malignancy followed by ovary, uterus, vulva and vagina. Five-year survival rate of stage I, II, III, IV cervical cancer were 50%, 40%, 20%, and 0% respectively. Overall five-year survival rate of carcinoma of the ovary was 54.8%. If sub-classified by stage, five-year survival rate are 94.3%, 75.0%, 31%, and 11.7% for stage I, II, III, and IV respectively. Five-year disease-free survival rate of endometrial cancer was 71.9%. Indonesia is the biggest Archipelago with a dense population but the income per capita still low (poor country). The most common gynecologic cancer is cervical cancer, followed by ovarian and uterine cancer. These cancers are included in top ten cancers in Indonesia. HPV 16, 18 were the most cause of cervical cancer. The five-year survival rates are comparable with world report.
Disease-Free Survival ; Endometrial Neoplasms ; Female ; Genital Neoplasms, Female ; Gross Domestic Product ; Human papillomavirus 16 ; Humans ; Indonesia ; Life Expectancy ; Ovarian Neoplasms ; Ovary ; Specialization ; Survival Rate ; United Nations ; Uterine Cervical Neoplasms ; Uterine Neoplasms ; Uterus ; Vagina ; Vulva

AIMTo assess heme oxygenase-1 (HO-1) activity in the cavernous tissue of sildenafil citrate-treated rats.

METHODSOne hundred and ninety-two Sprague-Dawley male rats, divided into four equal groups, were investigated. Group 1, the control group, received regular animal chow; group 2 received sildenafil citrate by intragastric tube; group 3 received sildenafil and HO inhibitor (zinc protoporphyrin, ZnPP); and group 4 received sildenafil and nitric oxide synthase (NOS) inhibitor L-nitroarginine methyl ester (L-NAME). Twelve rats from each group were killed after 0.5 h, 1 h, 2 h and 3 h of drug administration. Then HO-1 activity, cGMP levels and NOS enzymatic activity in the cavernous tissues were estimated.

RESULTSIn cavernous tissue, HO-1 activity, NOS enzymatic activity and cGMP concentration increased significantly in sildenafil-treated rats compared to other groups throughout the experiment. Rats receiving either HO or NOS inhibitors showed a significant decrease in these parameters. HO-1 cavernous tissue activity and NOS enzymatic activity demonstrated a positive significant correlation with cGMP levels (r = 0.646, r = 0.612 respectively; P < 0.001).

CONCLUSIONThe actions of PDE5 inhibitor sildenafil citrate in the cavernous tissue are partly mediated through the interdependent relationship between both HO-1 and NOS activities.

Administration, Oral ; Animals ; Cyclic GMP ; metabolism ; Drug Interactions ; Drug Therapy, Combination ; Enzyme Inhibitors ; pharmacology ; Heme Oxygenase-1 ; antagonists & inhibitors ; metabolism ; Male ; NG-Nitroarginine Methyl Ester ; pharmacology ; Nitric Oxide Synthase ; metabolism ; Penis ; drug effects ; enzymology ; Piperazines ; pharmacology ; Protoporphyrins ; pharmacology ; Purines ; pharmacology ; Rats ; Rats, Sprague-Dawley ; Sildenafil Citrate ; Sulfones ; pharmacology ; Vasodilator Agents ; pharmacology