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1.
Environ Sci Technol ; 57(43): 16265-16275, 2023 10 31.
Artículo en Inglés | MEDLINE | ID: mdl-37863474

RESUMEN

India is one of the largest emitters of atmospheric anthropogenic mercury (Hg) and the third-largest emitter of greenhouse gases in the world. In the past decade, India has been committed to the Minamata Convention (2017) in addition to the Paris Climate Change Agreement (2015) and the Glasgow Pact (2021). More than 70% to 80% of India's mercury and carbon dioxide emissions occur because of anthropogenic activities from coal usage. This study explores nine policy scenarios, the nationally determined contribution (NDC) scenario, and two deep decarbonization pathways (DDP) with and without mercury control technologies in the energy and carbon-intensive sectors using a bottom-up, techno-economic model, AIM/Enduse India. It is estimated that NDC scenarios reduce mercury emissions by 4%-10% by 2070; while coal intensive (DDP-CCS) pathways and focus on renewables (DDP-R) reduce emissions by 10%-54% and 15%-59%, respectively. Increase in the renewables share (power sector) can result in a significant reduction in the costs of additional pollution-abating technologies in the DDP-R scenario when compared with the coal intensive DDP-CCS scenario. However, the industry sector, especially iron and steel and metal production, will require stringent policies to encourage installation of pollution-abating technologies to mitigate mercury emissions under all the scenarios.


Asunto(s)
Contaminantes Atmosféricos , Mercurio , Contaminantes Atmosféricos/análisis , Mercurio/análisis , Contaminación Ambiental , India , Carbón Mineral/análisis
2.
Sci Total Environ ; 894: 164976, 2023 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-37336408

RESUMEN

As the post-pandemic world adjusts to a new normal, the deep decarbonization of the transport sector, which is essential for China's carbon neutrality, is likely to be faced with unprecedented challenges and opportunities. This study conducted scenario simulations to understand the role of the transport sector in achieving China's carbon neutral target in the context of the post-pandemic new normal. The simulation results showed that carbon dioxide (CO2) emissions could be significantly reduced by lifestyle changes in a post-pandemic world, while the reduction potential would be partially offset by the negative effects stemming from a decline in public transport and car-sharing services. It was also found that the arrival of the post-pandemic new normal could help reduce the mitigation cost required to meet the carbon neutral target. Because of regional disparities in the reduction potential of CO2 emissions and mitigation costs, transport decarbonization toward carbon neutrality requires region-specific policy packages.

3.
Nat Commun ; 13(1): 3629, 2022 Jun 24.
Artículo en Inglés | MEDLINE | ID: mdl-35750686

RESUMEN

The transport sector will play a pivotal role in achieving China's carbon neutrality goal by 2060. This study develops a regional transport-energy integrated model to analyze the long-term pathways and strategies toward the carbon-neutral ground transport sector in China. A set of scenarios are created to identify the effectiveness and feasibility of low-carbon policy measures based on the well-known transport strategies within the Avoid-Shift-Improve framework. Our simulations shed light on synergistic coupling and trade-offs among different strategies and instruments for prescribing a desirable mix of policy measures that maximize the synergies and minimize the trade-offs. Here, we show that a region-specific policy package designed from a balanced perspective under the Avoid-Shift-Improve framework has the potential to realize a deep decarbonization in the transport sector and will greatly assist in achieving China's carbon neutrality by 2060.

4.
Environ Pollut ; 261: 113650, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32078884

RESUMEN

This study analyzes emissions pathways and mitigation potentials of greenhouse gases (GHGs), air-pollution and short-lived climate pollutants (SLCPs), while taking mitigation actions for achieving a 2 °C global temperature change limit above pre-industrial levels, so-called "2 °C target." The study evaluates SLCPs (i.e. BC, CH4, tropospheric O3) mitigation scenarios by considering synergies and tradeoffs of various combinations of low-carbon measures and air pollutants control measures. It was found that, even if CO2 emissions pathways in this study are all similar to achieve the 2 °C target, reaching a carbon price at around 400 US$/tCO2eq. in 2050, SLCPs and air pollutants emissions pathways and mitigation potentials are largely influenced by combinations of some key mitigation measures. The maximum mitigation potential reductions of SLCPs (BC, CH4) and air pollutants (NOx, CO, NMVOC, which are precursors of tropospheric O3) in Asia are 89%, 22%, 67%, 37%, and 11% respectively by 2050 compared to the 2010 levels. After considering both direct SLCP reduction effects (i.e. mitigating BC, CH4) and indirect SLCP reduction effects (i.e. mitigating NOx, CO, NMVOC for reducing tropospheric O3 generation and atmospheric CH4 concentration), it can be adjudged that combinations of widespread promotion of renewable energies, drastic electrification in transport, residential and commercial sectors, high biofuel shares in the transport sector, and a certain level of deployment of removal devices would be effective SLCP mitigation scenarios.


Asunto(s)
Contaminantes Atmosféricos/análisis , Contaminación del Aire/análisis , Contaminantes Ambientales , Asia , Carbono , Cambio Climático
5.
Environ Int ; 130: 104881, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31200152

RESUMEN

Many studies have reported associations between air pollution and health impacts, but few studies have explicitly differentiated the economic effects of PM2.5 and ozone at China's regional level. This study compares the PM2.5 and ozone pollution-related health impacts based on an integrated approach. The research framework combines an air pollutant emission projection model (GAINS), an air quality model (GEOS-Chem), a health model using the latest exposure-response functions, medical prices and value of statistical life (VSL), and a general equilibrium model (CGE). Results show that eastern provinces in China encounter severer loss from PM2.5 and more benefit from mitigation policy, whereas the lower income western provinces encounter severer health impacts and economic burdens due to ozone pollution, and the impact in southern and central provinces is relatively lower. In 2030, without control policies, PM 2.5 pollution could lead to losses of 2.0% in Gross Domestic Production (GDP), 210 billion Chinese Yuan (CNY) in health expenditure and a life loss of around 10,000 billion, while ozone pollution could contribute to GDP loss by 0.09% (equivalent to 78 billion CNY), 310 billion CNY in health expenditure, and a life loss of 2300 billion CNY (equivalent to 2.7% of GDP). By contrast, with control policies, the GDP and VSLs loss in 2030 attributable to ambient air pollution could be reduced significantly. We also find that the health and economic impacts of ozone pollution are significantly lower than PM2.5, but are much more difficult to mitigate. The Chinese government should promote air pollution control policies that could jointly reduce PM2.5 and ozone pollution.


Asunto(s)
Contaminación del Aire , Modelos Teóricos , Ozono , Material Particulado , Contaminantes Atmosféricos/efectos adversos , Contaminantes Atmosféricos/análisis , Contaminantes Atmosféricos/economía , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Contaminación del Aire/economía , China , Exposición a Riesgos Ambientales/efectos adversos , Exposición a Riesgos Ambientales/análisis , Exposición a Riesgos Ambientales/economía , Humanos , Ozono/efectos adversos , Ozono/análisis , Ozono/economía , Material Particulado/efectos adversos , Material Particulado/análisis , Material Particulado/economía
7.
Oncol Lett ; 14(1): 776-786, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28693233

RESUMEN

Krebs von den Lungen-6 (KL-6), a mucinous sialylated sugar chain on human mucin-1 glycoprotein (MUC1), is a diagnostic marker for interstitial lung diseases. Furthermore, elevated serum KL-6 levels have been observed in certain malignant tumor types of epithelial origin. The expression of MUC1 has been observed in patients with epithelial ovarian cancer (EOC) and is considered a potential therapeutic target. In the present study, KL-6 serum levels were investigated in patients clinically suspected of having malignant ovarian tumors. A total of 219 patients were enrolled in the study, which analyzed their serum KL-6 levels in addition to tumor expression of MUC1 using immunohistochemistry. High serum KL-6 levels were predominantly observed in patients with EOC, and did not occur in patients with benign or borderline tumors. The level of serum KL-6 was highly correlated with tumor stage, grade and histological type, and demonstrated superior sensitivity for the detection of ovarian cancer compared with that of serum cancer antigen 125. High serum KL-6 was significantly associated with shorter progression-free survival. In addition, tumor MUC1 expression status was significantly correlated with serum KL-6 levels. These data suggest that serum KL-6 may be a useful, non-invasive biomarker surrogate for tumor MUC1 expression in future clinical trials of MUC1-targeted therapy.

8.
Mol Diagn Ther ; 21(2): 187-198, 2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-28160193

RESUMEN

BACKGROUND: The cell surface glycoprotein mesothelin is highly expressed in several malignant diseases. Normal mesothelin expression is limited to mesothelial cells lining the pleura, peritoneum, and pericardium, making it a biomarker and an attractive target for cancer therapy. METHODS: We investigated tumor mesothelin expression and serum mesothelin levels in patients with epithelial ovarian cancer or borderline tumors. In total, 161 patients selected from a previous prospective study were analyzed for tumor mesothelin expression using immunohistochemistry and serum mesothelin expression using enzyme-linked immunosorbent assay. RESULTS: Eighty-eight (68.8%) epithelial ovarian cancers and eight (24.2%) borderline tumors showed high mesothelin expression, which was associated with shorter progression-free and overall survival. The tumor mesothelin expression status was moderately correlated with serum mesothelin levels in epithelial ovarian cancer patients. Based on receiver operating characteristic analysis, a serum mesothelin level above 2.20 nM predicted high tumor mesothelin expression in epithelial ovarian cancer patients (area under the curve = 0.81). In 45 patients with recurrent epithelial ovarian cancer, we observed relatively lower levels of serum mesothelin, compared to the level at the primary diagnosis. We also tracked the change in the serum mesothelin level during the course of second-line chemotherapy and found a discrepancy between the clinical response and the serum mesothelin change in some patients, which suggested tumor heterogeneity among the tumor cells with or without mesothelin expression. CONCLUSION: Serum mesothelin may be a useful noninvasive biomarker surrogate for tumor mesothelin expression in future clinical trials for mesothelin-targeted therapy.


Asunto(s)
Biomarcadores de Tumor , Proteínas Ligadas a GPI/sangre , Proteínas Ligadas a GPI/metabolismo , Neoplasias Glandulares y Epiteliales/sangre , Neoplasias Glandulares y Epiteliales/metabolismo , Neoplasias Ováricas/sangre , Neoplasias Ováricas/metabolismo , Adulto , Anciano , Carcinoma Epitelial de Ovario , Femenino , Expresión Génica , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Mesotelina , Persona de Mediana Edad , Clasificación del Tumor , Estadificación de Neoplasias , Neoplasias Glandulares y Epiteliales/diagnóstico , Neoplasias Glandulares y Epiteliales/mortalidad , Neoplasias Ováricas/diagnóstico , Neoplasias Ováricas/mortalidad , Pronóstico , Curva ROC , Recurrencia , Factores de Riesgo , Carga Tumoral
9.
Environ Sci Technol ; 50(9): 4836-43, 2016 05 03.
Artículo en Inglés | MEDLINE | ID: mdl-27063584

RESUMEN

This study evaluates the PM2.5 pollution-related health impacts on the national and provincial economy of China using a computable general equilibrium (CGE) model and the latest nonlinear exposure-response functions. Results show that the health and economic impacts may be substantial in provinces with a high PM2.5 concentration. In the WoPol scenario without PM2.5 pollution control policy, we estimate that China experiences a 2.00% GDP loss and 25.2 billion USD in health expenditure from PM2.5 pollution in 2030. In contrast, with control policy in the WPol scenario, a control investment of 101.8 billion USD (0.79% of GDP) and a gain of 1.17% of China's GDP from improving PM2.5 pollution are projected. At the provincial level, GDP loss in 2030 in the WoPol scenario is high in Tianjin (3.08%), Shanghai (2.98%), Henan (2.32%), Beijing (2.75%), and Hebei (2.60%) and the top five provinces with the highest additional health expenditure are Henan, Sichuan, Shandong, Hebei, and Jiangsu. Controlling PM2.5 pollution could bring positive benefits in two-thirds of provinces. Tianjin, Shanghai, Beijing, Henan, Jiangsu, and Hebei experience most benefits from PM2.5 pollution control as a result of a higher PM2.5 pollution and dense population distribution. Conversely, the control investment is higher than GDP gain in some underdeveloped provinces, such as Ningxia, Guizhou, Shanxi, Gansu, and Yunnan.


Asunto(s)
Contaminación Ambiental , Modelos Teóricos , Beijing , China , Humanos , Material Particulado
10.
Int J Gynecol Cancer ; 26(3): 443-8, 2016 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-26807640

RESUMEN

OBJECTIVE: Paclitaxel is known to produce the "platelet-sparing effect" that prevents the carboplatin-induced decrease in platelet count. We conducted a pilot study to assess whether the addition of low-dose paclitaxel to carboplatin-based combination chemotherapy prevents thrombocytopenia. METHODS: Patients with platinum-sensitive recurrent ovarian cancer received intravenous (IV) paclitaxel at 60 mg/m(2) followed by IV carboplatin at an area under the curve of 6 and IV pegylated liposomal doxorubicin at 30 mg/m(2) on day 1 in a 28-day cycle (DC-LOP) or IV gemcitabine at 1000 mg/m(2) on days 1 and 8 in a 21-day cycle (GC-LOP). RESULTS: During May 2011 to December 2011, 7 patients received 29 cycles of DC-LOP; during January 2012 to May 2013, 15 patients received 88 cycles of GC-LOP. Grade 3/4 thrombocytopenia occurred in 2 (33%) of 6 and 9 (56%) of 16 patients in the DC-LOP and GC-LOP groups, respectively. No grade 3/4 nonhematological toxicity was observed. Only one patient who received GC-LOP had grade 2 sensory and motor peripheral neuropathy. Paclitaxel-related toxicities, including muscle pain, arthralgia, and peripheral neuropathy, were consistently rare and mild. The response rates of DC-LOP and GC-LOP were 33% (0, complete response; 2, partial response; 3, stable disease; 1, progression disease) and 50% (2, complete response; 6, partial response; 7, stable disease; 1, progression disease), respectively. CONCLUSIONS: Although low-dose paclitaxel addition did not alleviate thrombocytopenia in the setting of this pilot study, the results do not deny the existence of the "platelet-sparing effect" by low-dose paclitaxel. Further investigation of the carboplatin-based combination chemotherapy including a drug with mild hematological toxicity is warranted.


Asunto(s)
Adenocarcinoma de Células Claras/tratamiento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinosarcoma/tratamiento farmacológico , Cistadenocarcinoma Seroso/tratamiento farmacológico , Neoplasias Endometriales/tratamiento farmacológico , Neoplasias Ováricas/tratamiento farmacológico , Adenocarcinoma de Células Claras/patología , Adulto , Anciano , Carboplatino/administración & dosificación , Carcinosarcoma/patología , Cistadenocarcinoma Seroso/patología , Desoxicitidina/administración & dosificación , Desoxicitidina/análogos & derivados , Relación Dosis-Respuesta a Droga , Doxorrubicina/administración & dosificación , Doxorrubicina/análogos & derivados , Neoplasias Endometriales/patología , Femenino , Estudios de Seguimiento , Humanos , Persona de Mediana Edad , Invasividad Neoplásica , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/patología , Estadificación de Neoplasias , Neoplasias Ováricas/patología , Paclitaxel/administración & dosificación , Proyectos Piloto , Polietilenglicoles/administración & dosificación , Pronóstico , Inducción de Remisión , Estudios Retrospectivos , Tasa de Supervivencia , Gemcitabina
11.
Int J Cancer ; 138(8): 1994-2002, 2016 Apr 15.
Artículo en Inglés | MEDLINE | ID: mdl-26595060

RESUMEN

Folate receptor alpha (FRA) is a GPI-anchored glycoprotein and encoded by the FOLR1 gene. High expression of FRA is observed in specific malignant tumors of epithelial origin, including ovarian cancer, but exhibits very limited normal tissue expression, making it as an attractive target for the ovarian cancer therapy. FRA is known to shed from the cell surface into the circulation which allows for its measurement in the serum of patients. Recently, methods to detect the soluble form of FRA have been developed and serum FRA (sFRA) is considered a highly promising biomarker for ovarian cancer. We prospectively investigated the levels of sFRA in patients clinically suspected of having malignant ovarian tumors. A total of 231 patients were enrolled in this study and analyzed for sFRA as well as tumor expression of FRA by immunohistochemistry. High sFRA was predominantly observed in epithelial ovarian cancer patients, but not in patients with benign or borderline gynecological disease or metastatic ovarian tumors from advanced colorectal cancers. Levels of sFRA were highly correlated to clinical stage, tumor grade and histological type and demonstrated superior accuracy for the detection of ovarian cancer than did serum CA125. High sFRA was significantly associated with shorter progression-free survival in both early and advanced ovarian cancer patients. Finally, tumor FRA expression status was strongly correlated with sFRA levels. Taken together, these data suggest that sFRA might be a useful noninvasive serum biomarkers for future clinical trials assessing FRA-targeted therapy.


Asunto(s)
Biomarcadores de Tumor/sangre , Receptor 1 de Folato/sangre , Neoplasias Glandulares y Epiteliales/diagnóstico , Neoplasias Ováricas/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Carcinoma Epitelial de Ovario , Supervivencia sin Enfermedad , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Persona de Mediana Edad , Neoplasias Glandulares y Epiteliales/sangre , Neoplasias Glandulares y Epiteliales/mortalidad , Neoplasias Ováricas/sangre , Neoplasias Ováricas/mortalidad , Pronóstico , Estudios Prospectivos , Curva ROC , Sensibilidad y Especificidad , Adulto Joven
12.
Springerplus ; 4: 520, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26405640

RESUMEN

In 2014, we published an article titled "Novel uterine sarcoma preoperative diagnosis score predicts the need for surgery in patients presenting with a uterine mass" on the preoperative diagnosis of uterine sarcoma, in the SpringerPlus (Nagai et al. in SpringerPlus 2014, 3:678. doi:10.1186/2193-1801-3-678). Subsequently, we received several suggestions from readers, which were used to modify the statistical analysis methods and create a more precise preoperative diagnostic scoring system, which we present here as a supplemental report. The subjects were 63 patients who underwent surgical therapy for suspected uterine sarcoma (sarcoma group: 15 patients, benign group: 48 patients). Logistic regression analysis using the exact method was performed considering the subjects' preoperative age, serum lactate dehydrogenase levels, magnetic resonance imaging findings, and endometrial cytology findings. We then used parameter estimates obtained from this analysis to revise the PREoperative Sarcoma Score (PRESS). The revised PRESS (rPRESS) has a maximum score of 10 points and an optimal cut-off value of 4 points, as derived from a receiver operating characteristic curve. Using this, the accuracy, positive predictive value, and negative predictive value were 93.7, 92.3, and 94.0 %, respectively. The diagnostic precision of the rPRESS is better than that of the original PRESS.

13.
Oncol Res Treat ; 38(6): 276-81, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26045023

RESUMEN

BACKGROUND: This study aimed to determine the efficacy of the risk of ovarian malignancy algorithm (ROMA), calculated using the carbohydrate antigen 125 (CA125) and human epididymis protein 4 (HE4) levels and the menopausal status, as a predictor of peritoneal dissemination in ovarian cancer. METHODS: The CA125 and HE4 levels and the ROMA were compared between ovarian cancer patients (n = 122) with or without peritoneal dissemination. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated, and the results were compared with those of computed tomography (CT). RESULTS: The CA125, HE4, and ROMA values differed significantly depending on the presence of peritoneal dissemination (p < 0.0001). The cut-off values were 181 U/ml for CA125, 161 pmol/ml for HE4, 44% for the ROMA (premenopausal), and 86% for the ROMA (postmenopausal). Among these markers, the ROMA (premenopausal) was the strongest predictor of peritoneal dissemination, with a specificity of 85.0% and a positive predictive value of 81.3%. In addition, the detection rates of small disseminations with less than 2 cm in diameter for the ROMA (93%) and HE4 (60%) were superior to that of CT (53%). CONCLUSIONS: The ROMA was a significant predictor of peritoneal dissemination and may be superior to CT for the detection of patients with small disseminations.


Asunto(s)
Algoritmos , Biomarcadores de Tumor/sangre , Antígeno Ca-125/sangre , Neoplasias Glandulares y Epiteliales/patología , Neoplasias Ováricas/patología , Neoplasias Peritoneales/secundario , Proteínas/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma Epitelial de Ovario , Reacciones Falso Positivas , Femenino , Humanos , Técnicas para Inmunoenzimas , Persona de Mediana Edad , Neoplasias Glandulares y Epiteliales/sangre , Neoplasias Glandulares y Epiteliales/diagnóstico por imagen , Neoplasias Ováricas/sangre , Neoplasias Ováricas/diagnóstico por imagen , Neoplasias Peritoneales/sangre , Neoplasias Peritoneales/diagnóstico por imagen , Posmenopausia , Valor Predictivo de las Pruebas , Premenopausia , Factores de Riesgo , Sensibilidad y Especificidad , Tomografía Computarizada por Rayos X , Proteína 2 de Dominio del Núcleo de Cuatro Disulfuros WAP
14.
Springerplus ; 4: 102, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25763309

RESUMEN

INTRODUCTION: Primary malignant melanoma of the vagina is an extremely rare disease affecting 3% of patients with malignant vaginal tumors. It is rare compared to primary malignant melanoma of the skin and its prognosis is unfavorable even in patients with Stage I disease. Here, we report a case of primary malignant melanoma of the vagina and discuss our experience with regard to previously published literature. CASE DESCRIPTION: The patient was a 59-year-old female with 2 prior pregnancies and child births. She was examined by a local doctor for swelling of the genitalia, and a 1.8 × 1.0 cm large tumor was detected on the left side of the vaginal wall. A biopsy indicated leiomyosarcoma, and she was referred to our hospital. The tumor was resected, and histopathology of the resected sample confirmed the diagnosis of malignant melanoma based on a positive surgical margin. Additional courses of treatment included left inguinal sentinel lymph node biopsy using an isotope and extended vaginectomy. Although the sentinel node was negative, we performed a modified radical hysterectomy and left vaginectomy during the third operation because the surgical margin was positive. We could not confirm whether the lesion in the extracted sample was malignant, and the final diagnosis was primary malignant melanoma of the vagina T4bN0M0 Stage IIc (UICC 2009). Postoperative adjuvant therapy consisted of 6 cycles of DAV-Feron therapy (dacarbazine, ACNU, vincristine, IFN- ß). After 5 months of postoperative adjuvant therapy, a 2 cm single lung metastasis was detected in the lower left lung. We performed a laparoscopic lower left lobectomy and are planning additional chemotherapy. DISCUSSION AND EVALUATION: Currently, surgical resection has the highest probability of improving the prognosis of patients when used as initial treatment for Stage I disease. By combining treatment with sentinel lymph node biopsy, we were able to accurately determine the stage of disease and thus avoid systematic lymph node dissection and further surgical treatments. CONCLUSION: Malignant melanoma of the vagina is very rare tumor so it is necessary to requires the integration of further cases.

15.
Oncology ; 88(2): 86-94, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25324024

RESUMEN

BACKGROUND: Endometrial cytology by direct intrauterine sampling is the most common test for an initial evaluation of the endometrium in Japan. However, its diagnostic value for endometrial cancer remains unknown. Here, we assess the correlation between cytopathology and histopathology to evaluate the diagnostic value of cytology for endometrial cancer. METHODS: Patients with histologically confirmed endometrial cancer and controls with a normal endometrium confirmed by hysterectomy had all undergone preoperative endometrial cytology between 2001 and 2010 at our eight institutions and were retrospectively analyzed. The cytological results were compared by clinical stage, histological type, differentiation, and sampling instrument. RESULTS: We analyzed 1,441 endometrial cancer and 1,361 control cases. Endometrial cytology detected cancer in 1,279 (916 positive and 363 suspicious) cases with a sensitivity (positive plus suspicious cases) of 88.8% and a specificity of 98.5%. The positive rate was high in advanced-stage, nonendometrioid, and undifferentiated cases, but there was no significant difference in sensitivity between these clinical conditions. CONCLUSION: Endometrial cytology shows a relatively high sensitivity and specificity for endometrial cancer, and neither statistical measure is significantly affected by clinical stage, histological type, differentiation, sample numbers, or sampling instrument. These findings form a superior dataset for evaluating the efficacy of endometrial cytology.


Asunto(s)
Neoplasias Endometriales/patología , Endometrio/patología , Anciano , Biopsia , Femenino , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias
16.
Springerplus ; 3: 678, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25520907

RESUMEN

Preoperative diagnosis of uterine sarcoma is very difficult, and currently, its diagnostic accuracy is not satisfactory. It is therefore important to perform surgery and establish the pathological diagnosis if the clinical findings and various examination findings indicate possible uterine sarcoma. We investigated the accuracy of the combination of various types of predictors of uterine sarcoma and the novel PREoperative Sarcoma Score (PRESS) for avoiding unnecessary surgery while diagnosing uterine sarcoma. We retrospectively analyzed the clinical findings, blood tests, imaging studies (ultrasonography and magnetic resonance imaging [MRI]), and endometrial cytology of 63 suspected uterine sarcoma cases that underwent surgery from 2006 to 2012. These cases were also scored retrospectively using PRESS. We analyzed the number of unnecessary surgeries that could be avoided using PRESS. Of 63 cases, 15 were diagnosed with uterine sarcoma (sarcoma group), and 48 had benign tumors (benign group). Univariate analysis indicated age, serum lactate dehydrogenase (LDH) values, and MRI and endometrial cytology findings as significant predictors of uterine sarcoma in both groups. In contrast, multivariable analysis identified only age, serum LDH value, and endometrial cytology findings as significant predictors. Accordingly, the latter were placed as 2 points, and the remaining MRI finding as 1 point. The accuracy rate of prediction was 84.1%, and the positive and negative predictive values were 63.2% and 93.2% respectively when the PRESS was interpreted as "positive" when it was 3 points or higher. Using multiple predictors for the preoperative diagnosis of uterine sarcoma, our proposed PRESS score is beneficial in the clinical setting while making treatment decisions in suspected uterine sarcoma cases as well as avoiding unnecessary surgery.

17.
Jpn J Clin Oncol ; 44(11): 1040-4, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25183770

RESUMEN

OBJECTIVE: We evaluated the feasibility of combination chemotherapy with paclitaxel, doxorubicin and cisplatin without prophylactic granulocyte colony-stimulating factor injection for intermediate-to-high-risk or recurrent endometrial cancer. METHODS: Women with histologically confirmed FIGO Stages I-II with >1/2 myometrial invasion, Stage III/IV or recurrent endometrial cancer were enrolled. Patients received intravenous doxorubicin (45 mg/m(2)), followed by cisplatin (50 mg/m(2)) on Day 1 and intravenous paclitaxel (160 mg/m(2)) on Day 2. Granisetron (75 µg) was administered depending on neutrophil counts on Days 3 and 8. Treatment was repeated every 21 days for six cycles or until disease progression or unacceptable toxicity. The primary endpoint was the completion rate of the scheduled chemotherapy; secondary endpoints were Grade 3/4 toxicity and response rate in patients with measurable lesions. RESULTS: From September 2010 to December 2012, 35 women, including 7 with FIGO Stage I, 4 with Stage II, 13 with Stage III, 10 with Stage IV and 1 with recurrent endometrial cancer, were enrolled. There were 26 endometrial carcinomas (Grade 1, 16; Grade 2, 6; Grade 3, 4), 4 carcinosarcomas, 2 serous adenocarcinomas, 1 neuroendocrine carcinoma, 1 poorly differentiated carcinoma and 1 mixed carcinoma. Twenty-five patients (71%) completed six chemotherapy cycles. Grade 3/4 hematological toxicities included neutrocytopenia (97%), thrombocytopenia (6%) and anemia (34%). Three patients (9%) experienced neutropenic fever. Grade 3/4 non-hematological toxicities were observed in 13 patients. In 15 patients with evaluable lesions, the response rate was 80%. CONCLUSIONS: Combination chemotherapy with paclitaxel, doxorubicin and cisplatin without prophylactic granulocyte colony-stimulating factor injection is feasible.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carcinoma/tratamiento farmacológico , Neoplasias Endometriales/tratamiento farmacológico , Neoplasias Endometriales/patología , Recurrencia Local de Neoplasia/tratamiento farmacológico , Anciano , Anemia/inducido químicamente , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carcinoma/secundario , Cisplatino/administración & dosificación , Cisplatino/efectos adversos , Doxorrubicina/administración & dosificación , Doxorrubicina/efectos adversos , Esquema de Medicación , Estudios de Factibilidad , Femenino , Factor Estimulante de Colonias de Granulocitos/administración & dosificación , Humanos , Persona de Mediana Edad , Estadificación de Neoplasias , Neutropenia/inducido químicamente , Paclitaxel/administración & dosificación , Paclitaxel/efectos adversos , Medición de Riesgo , Factores de Riesgo , Trombocitopenia/inducido químicamente , Resultado del Tratamiento
18.
Environ Pollut ; 195: 336-43, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25028265

RESUMEN

This study analyzes the potential to reduce air pollutants while achieving the 2 °C global temperature change limit target above pre-industrial levels, by using the bottom-up optimization model, AIM/Enduse[Global]. This study focuses on; 1) estimating mitigation potentials and costs for achieving 2 °C, 2.5 °C, and 3 °C target scenarios, 2) assessing co-benefits of reducing air pollutants such as NOx, SO2, BC, PM, and 3) analyzing features of sectoral attributions in Annex I and Non-Annex I groups of countries. The carbon tax scenario at 50 US$/tCO2-eq in 2050 can reduce GHG emissions more than the 3 °C target scenario, but a higher carbon price around 400 US$/tCO2-eq in 2050 is required to achieve the 2 °C target scenario. However, there is also a co-benefit of large reduction potential of air pollutants, in the range of 60-80% reductions in 2050 from the reference scenario while achieving the 2 °C target.


Asunto(s)
Contaminantes Atmosféricos/análisis , Cambio Climático , Restauración y Remediación Ambiental/métodos , Política Ambiental , Restauración y Remediación Ambiental/economía , Modelos Teóricos , Temperatura
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