Objectives This study aims to investigate the modulation of estrogen receptors by estrogen and the role of genistein in the transcriptional process that regulates genes involved in the proliferation, apoptosis, and telomere activity. Methods The research was conducted in silico , wherein docking, the most important method, was carried out using Hex 8.0 software and HADDOCK web server. Interaction analysis was subsequently done to observe the interactions between genistein and several related proteins and BCLX, Casp3, Ki-67, CyclinD1, hTERT, and POT1 genes using Discovery Studio, LigPlus, and NUCPLOT. Results The interaction between ERα with genistein was not found to form a single bond. Thus, the interaction that may occur will not be effective because it is not stable. Conversely, when interacting with ERβ, two hydrogen bonds and four hydrophobic bonds, MPP dihydrochloride interacted with ERα via two hydrogen bonds and three hydrophobic bonds. The ERβ/eNOS complex will be comparatively easier to induced by the transcriptional activation of BCLX, Casp3, Ki-67, CyclinD1, hTERT and POT1 genes. Conclusions Administration of genistein can increase the genomic activities of the estrogen-eNOS receptor complexes related to apoptosis, proliferation, and telomere activity.

Patient: Female, 3 Final Diagnosis: Recurrent sarcoma botryoides Symptoms: Vaginal mass Medication: — Clinical Procedure: Surgical resection • adjuvant chemotherapy Specialty: Obstetrics and Gynecology Objective: Unusual setting of medical care Background: Sarcoma botryoides, known as embryonal rhabdomyosarcoma (ERMS), is a malignant tumor which arises from embryonic muscle cells. The incidence of ERMS in the uterine cervix rarely occurs at a very young age. With sufficient resources, management of this disease is not difficult. However, in limited resources settings, such as in Indonesia, the situation is more challenging. This case report aims to highlight the difficulties encountered in diagnosing and treating patients with sarcoma botryoides. Case Report: A 3-year-old female patient came the outpatient clinic of our hospital with a protruding mass from her vagina resembling a bunch of grapes which easily bled. She underwent surgery to remove the mass. After the procedure, she did not return to the hospital for the recommended adjuvant chemotherapy treatment due to limited funds. Three months later, she came to the outpatient clinic with the same complaint, despite smaller size. Due to limited resources, we only evaluated the metastasis using chest x-ray and did not perform intra-operative biopsy. In the second surgery, a wide excision with 1–2 cm margin was performed, followed by adjuvant chemotherapy for 6 series. We achieved a satisfactory outcome in this case, and 18 months after the surgery, the patient was still in remission. Conclusions: Sarcoma botryoides is a rare malignancy. The effective treatment for sarcoma botryoides is wide excision with safe margin of 1–2 cm, followed by 6–12 cycles of vincristine, actinomycin D, and cyclophosphamide (VAC) regiment as an adjuvant chemotherapy. A family’s understanding of the treatment plan is important to achieve desired outcomes. Even with limited resources, this malignancy can still be properly treated.

Background & aims: Choriocarcinoma is a malignant trophoblastic tumor. The phosphorylation of estrogen receptor-a at serine 118 (p-ER-s118) decreases cancer cell proliferation. However, the effect of genistein as a modulator of pER -s118 and proliferation of chorioarcinoma cells remains to be understood. This study aims at determining the function of genistein on pER -s118 levels and human choriocarcinoma JEG-3 cell proliferation. Methods: After reaching confluency, cells were divided into six groups, the control group (without methyl-piperidino-pyrazole (MPP) pre-treatment and genistein treatment); and groups with cells treated with genistein at concentrations of 0, 10, 25, 50, and 100 mM (cells were pretreated with MPP). Expression of pER -s118 and Ki-67 were analyzed using immunocytochemistry. Results: Different doses of genistein decreased pER -s118 levels compared to those in the control (p < 0.05). JEG-3 cell proliferation was inhibited by MPP pre-treatment, concomitant with genistein treatment with a dose of 0 mM, 25 mM, 50 mM, and 100 mM compared to the proliferation of the control cells (p < 0.05).

Cervical cancer has several cell types, squamous cell carcinoma, adenocarcinoma and others. The level of progression of cervical cancer is determined by the degree of cell differentiation, which is classified into well, moderate and poor differentiation. The neutrophil lymphocyte ratio (NLR) can assess the progression of cervical cancer. The higher the NLR, the higher the level of progression and the worse the degree of cell differentiation. This research is an analytical study using secondary data. The results obtained were 88 cervical cancer subjects with squamous cell carcinoma type and only 41 subjects (46,6%) included in inclusion criteria of this study. In this study, there were 9 subjects of cervical cancer squamous cell carcinoma type with well-differentiated (22,0%), 26 subjects with moderately differentiated (63,5%) and 6 subjects with poorly differentiated (14,5%). The results of NLR for cervical cancer squamous cell carcinoma type well-differentiated has a mean of 1,5 with standard deviation of 1,2. The results of NLR for cervical cancer squamous cell carcinoma type moderately-differentiated has a mean of 3,4 with standard deviation of 2,3. The results of NLR for cervical cancer squamous cell carcinoma type poorly-differentiated has a mean of 5,5 with standard deviation of 3,7. Conclusion from this study is there was a significant difference of NLR in cervical cancer squamous cell carcinoma type in each differentiation. Keywords: cervical cancer squamous cell carcinoma type; well, moderately and poorly differentiated; NLR Abstrak: Kanker serviks mempunyai beberapa tipe sel, yaitu tipe karsinoma sel skuamosa, adenokarsinoma dan lain-lain. Tingkat progresivitas kanker serviks ditentukan dengan derajat diferensiasi sel, yang dibedakan menjadi diferensiasi baik, sedang dan buruk. Rasio neutrofil limfosit (RNL) dapat menilai progresivitas kanker serviks. Semakin tinggi RNL, maka semakin tinggi juga tingkat progresivitasnya dan derajat diferensiasi selnya semakin buruk. Penelitian ini bersifat studi analitik dengan menggunakan data sekunder. Hasil penelitian diperoleh 88 subjek kanker serviks tipe karsinoma sel skuamosa dan hanya 41 subjek (46,6%) yang memenuhi kriteria inklusi penelitian. Pada penelitian ini, terdapat 9 subjek kanker serviks tipe karsinoma sel skuamosa diferensiasi baik (22,0%), 26 subjek diferensiasi sedang (63,5%) dan 6 subjek diferensiasi buruk (14,5%). Hasil data RNL pada kanker serviks tipe karsinoma sel skuamosa diferensiasi baik memiliki rerata 1,5 dengan simpang baku 1,2. Hasil data RNL pada kanker serviks tipe karsinoma sel skuamosa diferensiasi sedang memiliki rerata 3,4 dengan simpang baku 2,3. Hasil data RNL kanker serviks tipe karsinoma sel skuamosa diferensiasi buruk memiliki rerata 5,5 dengan simpang baku 3,7. Kesimpulannya terdapat perbedaan bermakna RNL pada kanker serviks tipe karsinoma sel skuamosa antar diferensiasi. Kata-kata kunci: kanker serviks tipe karsinoma sel skuamosa; derajat diferensiasi baik, sedang dan buruk; RNL