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    • In contrast median Cu level

    2019-04-19

    In contrast, median Cu level (0.73 mg/L) in our study was approximately 50% lower than that in maternal blood (1.47 mg/L). Our result is consistent with several previously published studies, which showed a 50–60% decrease in Cu level in the fetus. The observed decrease in fetal Cu, a major metallic cofactor in a variety of oxidoreductases, may reduce the potential of cellular oxidative damage in the developing fetus. However, Cu is an essential mineral, and its deficiency can result in many nutritional and vascular disorders. Maintaining an adequate amount of Cu in the human body is important, especially for the newborns who are dependent on stored Cu. Prenatal vitamin use significantly decreased the maternal levels of Hg and Cu in this order Puromycin series. From animal studies, some data on the effect of vitamin E on heavy metals are available. Al-attar\'s study suggested that the administration of vitamin E protects against heavy metal-induced renal and testicular oxidative stress and injuries in male mice. Another Al-attar\'s study showed that vitamin E protects against the heavy metal-induced liver injury in albino mice, and the attenuating effect of vitamin E may be due to its antioxidant activity. Abd El-Aziz et al reported that vitamin E may ameliorate some aspects of methyl Hg developmental toxicity in rat fetuses. Kim et al also found a negative association between serum folate and blood Hg concentrations in pregnant Korean women. Their findings suggest that folate is associated with the blood Hg level by participating in the Hg detoxification process. It is still unclear by which mechanism prenatal vitamin use can reduce maternal levels of Hg and Cu. The effect of vitamin use on heavy metals in pregnant woman still requires further investigation.
    Introduction In the past decade, transoral laser microsurgery (TLM) has been used to treat early and select cases of moderately advanced glottic cancer. The oncologic results of TLM are equivalent to those obtained by conventional conservative surgery and radiotherapy (RT). The advantages of TLM are reduced morbidity, shorter hospital stay, and better postoperative laryngeal function than with conventional conservation surgery. In fact, patients with subepithelial and subligamental cordectomies have been reported to have good voice outcomes. Compared with RT, patients undergoing endoscopic surgery have lower hidden costs including total travel time, total travel distance and total hours of work lost. The absence of RT-induced tissue toxicity and shorter treatment time also make TLM a more favorable initial treatment. In cases of local recurrence or second primary cancer in the head and neck area, TLM can be repeated and provide more treatment options than with initial RT or conventional conservative surgery. In addition, TLM does not interfere with alternative treatments because it preserves the laryngeal framework and vascularization. Furthermore, two literature reviews indicated that local control and survival rates were similar after TLM, conventional conservative surgery, and RT.
    Methods
    Results In this study, patients were predominantly male (97%), with a median age of 63 years (range 34 to 89 years). Seventy-three patients (78%) had a history of tobacco use and 36 (39%) had a history of alcohol consumption. The characteristics of the 93 patients are shown in Table 1. As classified by the American Joint Committee on Cancer 2002, the primary tumor stage was 18 Tis (19%), 38 T1 (41%), 20 T2 (22%), and 17 T3 (18%). In the 38 T1 patients, 32 (84%) were T1a and 6 (16%) were T1b stage. Seventeen patients (18%) had undergone microlaryngoscopic surgery (MLS) with mucosal stripping within 3 months before this operation. Ten patients (11%) had local recurrence after previous treatment, including 5 TLM and 5 RT. The types of TLM included 18 type I (19%), 31 type II (33%), 20 type III (22%), 3 type IV (3%), 15 type V (16%), and 6 type VI (6%). Five patients (5%) had DLE during TLM even though external compression was performed. Seven patients (8%) received postoperative RT due to positive surgical margin.