Non-endometrioid endometrial cancer: analysis of recurrence pattern and identification of prognostic and treatment factors affecting recurrence and survival.

PURPOSE: We investigated the characteristics of recurrence pattern and survival of patients with non-endometrioid endometrial cancer (NEEC) and attempted to identify prognostic and treatment factors affecting disease-free survival (DFS) and overall survival (OS) of these patients. METHODS: Fifty-seven patients with histologically confirmed International Federation of Gynecology and Obstetrics (FIGO) stage IA-IVA NEEC from February 2003 to December 2021 were retrospectively analyzed. RESULTS: The 5­year DFS and OS rates of the total cohort were 50.6% and 56.1%, respectively. Recurrence occurred in 28 patients (49.1%) during follow-up, and the most common recurrence pattern was distant metastasis (DM; 78.6% of total recurrences). The occurrence of relapse significantly reduced 5­year OS (recurrence group vs. non-recurrence group: 12.5% vs. 100%; p < 0.001). In univariate analysis, adjuvant radiotherapy (RT) group showed significantly higher 5­year DFS (56.7% vs. 37.9%; p = 0.04), local recurrence-free survival (91.6% vs. 50.5%; p = 0.01), and regional recurrence-free survival (88.2% vs. 56.5%; p < 0.01) than the non-RT group. In multivariate analysis, advanced FIGO stage was identified as a negative prognostic factor for DFS and OS. Lymphovascular space invasion (LVSI) and adjuvant RT were independent prognostic factors for DFS. CONCLUSION: The most common recurrence pattern observed in patients with NEEC was DM. FIGO stage and LVSI were identified as prognostic factors for survival, and RT was identified as a therapeutic modality that could increase DFS. To improve the OS of patients with NEEC, the addition of effective chemotherapy that can reduce DM may be important.

Comparative Analysis of Transforaminal Endoscopic Thoracic Discectomy and Microscopic Discectomy for Symptomatic Thoracic Disc Herniation.

OBJECTIVE: To evaluate the clinical outcomes of transforaminal endoscopic thoracic discectomy (TETD) and microscopic discectomy (MD) for the treatment of symptomatic thoracic disc herniation (TDH). METHODS: Seventy-seven patients (mean, 55.9 years; follow-up, 11.2 months) with symptomatic TDH were retrospectively reviewed (39 TETD and 38 MD). Radiological factors and perioperative outcomes were reviewed. Visual analogue scale (VAS), Oswestry Disability Index (ODI), and American Spinal Injury Association impairment scale were used to evaluate clinical and functional outcomes. Patient satisfaction was evaluated using modified MacNab criteria. RESULTS: The levels of surgery and the location of hernia were evenly distributed in the both groups. The operative time (70.6 minutes vs. 175.7 minutes), estimated blood loss (3.8 mL vs. 357.4 mL), and length of hospital stay (7.0 days vs. 13.0 days) were significantly different between the TETD and MD groups (p < 0.05). VAS scores for dorsal back pain and ODI scores were significantly improved in both groups (p < 0.05). Patients who underwent TETD tended to be more satisfied with the outcome in terms of the modified MacNab criteria (89.7% vs. 73.0%, p = 0.059). Two patients in the MD group underwent revision surgery, whereas one patient in the TETD group underwent MD because of incomplete decompression. CONCLUSION: TETD for the symptomatic TDH is a feasible and safe procedure that could be used for a wider range of surgical levels with a shorter operative time and hospital stay and less blood loss. While achieving similar outcomes, TETD achieved better patient satisfaction because of the use of local anesthesia and its minimal invasiveness.

Antioxidant Activity of Various Soluble Melanoidins Isolated from Black Garlic after Different Thermal Processing Steps.

To gain insight into the antioxidant activity of various soluble melanoidins isolated from black garlic after different thermal processing steps, the antioxidant activity was evaluated. Black garlic was produced in a ripening chamber using a programmed stepwise heating schedule as follows: Step 1, 90°C and 100% (RH) for 34 h; Step 2, 60°C and 60% RH for 6 h; Step 3, 75°C and 70% RH for 48 h; Step 4, 70°C and 60% RH for 60 h; Step 5, 65°C and 50% RH for 192 h. The melanoidins isolated from black garlic after the different thermal processing steps were divided into different melanoidin fractions, i.e., melanoidins, pure melanoidin, bound melanoidin compounds (BMC). The antioxidant activity of the melanoidins bound to low molecular weight compounds (BMC fraction) was generally higher than those of the pure melanoidins. Notably, the antioxidant activity of various soluble melanoidins differed according to the thermal processing steps. The results may be useful in predicting the behavior of various soluble melanoidins during thermal processing of garlic.

Comparative Analysis of Ginsenoside Profiles: Antioxidant, Antiproliferative, and Antigenotoxic Activities of Ginseng Extracts of Fine and Main Roots.

The aim of this study was to compare ginsenosides profiles, and antioxidant, antiproliferative, and antigenotoxic activities of ginseng extract derived from fine and main roots. The result of the analysis showed a higher total content of ginsenoside in fine roots than in main roots; differences in levels between the different extracts were also confirmed. The oxygen radical absorbance capacity (ORAC) assay showed that H2O main root extract had a significantly higher activity than that from fine roots. MeOH and H2O extracts from the fine and main roots also exhibited stronger cellular antioxidant capacity 2,2'-azobis(2-amidinopropane) dihydrochloride-induced oxidative stress in HepG2 cells compared with the positive control. Through calculating the half-maximal inhibitory concentration values, the cytotoxicity of the main root extracts were ranked as follows: MeOH (6.1±1.2 µg/mL)> H2O (6.6±0.1 µg/mL)> ethanol (10.4±0.6 µg/mL); however, the cytotoxicity of all fine root extracts did not significantly differ. All the fine root extracts showed an inhibitory capacity against 4-hydroxynonenal-induced DNA damage, however only the MeOH extract of the main root showed a decrease in DNA damage. All three solvent extracts from the fine roots reduced DNA damage more in the H2O2-treated group, whereas only the MeOH and H2O extracts of the main roots produced a significant reduction. Levels of Rg3 ginsenoside were positively correlated with indices of the ORAC value, and total ginsenoside contents showed a negative correlation with DNA damage induced by H2O2. This study suggests that ginseng and the extraction solvent both affect levels of ginsenoside. Furthermore, the antioxidant potency of ginseng can be attributed to the content of some ginsenosides.

Antioxidant Activities of Selected Berries and Their Free, Esterified, and Insoluble-Bound Phenolic Acid Contents.

To explore the potential of berries as natural sources of bioactive compounds, the quantities of free, esterified, and insoluble-bound phenolic acids in a number of berries were determined. In addition, the antioxidant activities of the berries were determined using 2,2-diphenyl-1-picrylhydrazyl radical scavenging activity, ferric reducing antioxidant power, and Trolox equivalent antioxidant capacity assays, in addition to determination of their metal ion chelating activities. Furthermore, several phenolic compounds were detected using high-performance liquid chromatography. Of the 6 tested berries, black chokeberry and blackberry exhibited the strongest antioxidant activities, and the various berry samples were found to contain catechin, caffeic acid, p-coumaric acid, epicatechin, vanillic acid, quercitrin, resveratrol, morin, naringenin, and apigenin. Moreover, the antioxidant activities and total phenolic contents of the fractions containing insoluble-bound phenolic acids were higher than those containing the free and esterified phenolic acids. The results imply that the insoluble-bound fractions of these berries are important natural sources of antioxidants for the preparation of functional food ingredients and preventing diseases associated with oxidative stress.

Adherence to endocrine therapy in breast cancer adjuvant and prevention settings.

Adherence to oral endocrine therapy in adjuvant breast cancer settings is a substantial clinical problem. To provide current perspective on adherence to oral endocrine therapies, a comprehensive literature review was conducted. In adjuvant trials, endocrine therapy adherence is relatively high with greater adherence for aromatase inhibitors compared with tamoxifen. In contrast, adherence to adjuvant therapy in clinical practice is relatively poor, with only about 50% of women successfully completing 5-year therapy. Importantly, good adherence (>80% use) has been associated with lower recurrence risk. Endocrine therapy adherence in primary breast cancer prevention trials parallels that seen in adjuvant trials. Factors associated with nonadherence include low recurrence risk perception, side effects, age extremes, medication cost, suboptimal patient-physician communication, and lack of social support. Few prospective studies have evaluated interventions designed to improve adherence. Interventions currently proposed reflect inferences from clinical trial procedures in which clinical contacts are commonly greater than in usual practice settings. In conclusion, for optimal breast cancer outcome, adherence to endocrine therapy must improve. Although general recommendations likely to improve adherence can be made based on clinical trial results and preliminary prospective trial findings, research specifically targeting this issue is needed to establish effective intervention strategies.

Cytotoxic and anti-inflammatory effects of onion peel extract on lipopolysaccharide stimulated human colon carcinoma cells.

The present study investigated the cytotoxic activity of ethanol extract of onion peel (OPE) in HT-29 human colon carcinoma cells. High-performance liquid chromatography (HPLC) analysis was performed to determine the amounts of phenolic acids and flavonoids in OPE. In addition, the influence of OPE on antioxidant- and inflammation-associated gene expression was also determined in a model of lipopolysaccharide (LPS)-stimulated HT-29 cells. HPLC analysis showed that OPE contained well-known antioxidant compounds, including p-coumaric acid, vanillic acid, epicatechin, and morin. After incubation with OPE, HT-29 cells showed either a loss of normal nuclear architecture or detachability from each other. The cytotoxic effects of OPE on HT-29 cells were confirmed by MTT and LDH release assays. LPS-induced oxidative conditions effectively downregulated TNF-α mRNA expression in OPE pretreated HT-29 cells compared with cells only stimulated with LPS. In addition, the expression of heme oxygenase-1 (HO-1) and glutathione S-transferase (GSTs) detoxification genes (i.e., GSTM1, GSTT1, and GSTP1) was upregulated after treatment with LPS at sublethal concentrations. However, the LPS-induced mRNA expression of HO-1 and GSTs was significantly attenuated by treatment with OPE. Therefore, onion peel extract is a promising component of future nutraceuticals and value-added products.