• Title/Summary/Keyword: PAP

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Performance of Siriraj Liquid-Based Cytology: a Single Center Report Concerning over 100,000 Samples

  • Sangkarat, Suthi;Laiwejpithaya, Somsak;Rattanachaiyanont, Manee;Chaopotong, Pattama;Benjapibal, Mongkol;Wongtiraporn, Weerasak;Laiwejpithaya, Sujera
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2051-2055
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    • 2014
  • Background: To evaluate the performance of Siriraj liquid-based cytology (LBC) for cervical neoplasia screening after increasing use of this technology. Materials and Methods: Cytological reports of 103,057 Siriraj-LBC specimens obtained in 2007-2009 were compared with those of 23,676 specimens obtained in 2006. Results: Comparing with the year 2006, the 2007-2009 patients were slightly older ($43.4{\pm}12.yr$ vs $42.7{\pm}12.2yr$, p <0.001), and their specimens had much lower proportion of unsatisfactory slides (OR=0.06, 95%CI 0.04-0.09) with comparable detection rates (3.96% vs 3.70%, p=0.052) but different proportions of various cytological abnormalities (p<0.001). The 2007-2009 Siriraj-LBC had a negative predictive value (NPV) for cervical intraepithelial neoplasia 2+ (CIN2+) of 97.6% and an overall positive predictive value (PPV) of 43.9%. The PPV for CIN2+ varied with types of abnormal cytology, from 13.7% to 93.8% in atypical squamous cells of undetermined significance (ASCUS), low-grade squamous intraepithelial lesion (LSIL), atypical squamous cells cannot exclude HSIL (ASC-H), high-grade squamous intraepithelial lesion (HSIL), atypical glandular cells (AGC), to squamous cell carcinoma (SCC), respectively. The PPVs for CIN2+ in ASCUS and LSIL were comparable, but the PPV for CIN1 was higher for LSIL than for ASCUS (41.63% vs 16.32%). Conclusions: Siriraj-LBC has demonstrated a stable detection rate and NPV for CIN2+ of >95% since the first year of use. The comparable PPVs for CIN2+ of ASCUS and LSIL suggests that these two conditions may undergo similar management; other cytological abnormalities need immediate evaluation.

Awareness of Cancer Screening During Treatment of Patients with Renal Failure: A Physician Survey in Turkey

  • Uysal-Sonmez, Ozlem;Tanriverdi, Ozgur;Uyeturk, Ummugul;Budakoglu, Isil Irem;Kazancioglu, Rumeyza;Turker, Ibrahim;Budakoglu, Burcin;Yalcintas-Arslan, Ulku;Oksuzoglu, Berna
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2165-2168
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    • 2014
  • Background: Today, survival rate of patients with chronic renal failure/hemodialysis has increased so that chronic illnesses are more likely to occur. Cancer is the main cause of morbidity and mortality in such patients. Aim: In this study, physician attitudes were examined about cancer screening in patients with renal failure. Materials and Methods: This study was done by face to face questionnaire in the $27^{th}$ National Nephrology Congress to determine if the physicians dealing with chronic renal failure, hemodialysis or renal transplanted patients, recommend cancer screening or not and the methods of screening for cervix, prostate, breast and colon cancer. Results: One hundred and fifty six physicians were included in the survey. A total of 105 (67%) participants were male and the age of responders was $48{\pm}9$ years. About 29% were specialists in nephrology, 28% internal medicine, and 5% were other areas of expertise. Some 48% of participants were hemodialysis certified general practitioners. Patients were grouped as compensated chronic renal failure, hemodialysis or renal transplanted. Of the 156 responders, 128 (82%) physicians recommended breast cancer screening and the most recommended subgroup was hemodialysis patients (15%). The most preferred methods of screening were combinations of mammography, self breast examination and physicianbreast examination. 112 (72%) physicians recommended cervix cancer screening, and the most preferred method of screening was pap-smear. Colon cancer screening was recommended by 102 (65%) physicians and prostate screening by 109 (70%) physicians. The most preferred methods of screening were fecal occult blood test and PSA plus rectal digital test, respectively. Conclusions: It is not obvious whether cancer screening in renal failure patients is different from the rest of society. There is a variety of screening methods. An answer can be found to these questions as a result of studies by a common follow-up protocol and cooperation of nephrologists and oncologists.

Detection of Human Papillomavirus in Male and Female Urine by Electrochemical DNA Chip and PCR Sequencing

  • Nilyanimit, Pornjarim;Wanlapakorn, Nasamon;Niruthisard, Somchai;Pohthipornthawat, Natkrita;Karalak, Anant;Laowahutanont, Piyawat;Phanuphak, Nittaya;Gemma, Nobuhiro;Poovorawan, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5519-5525
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    • 2013
  • Background: Cervical cancer is the second most common cancer in Thai women after breast cancer. Currently, the Papanicolaou (Pap) smear is the recommended procedure for cervical cancer screening in Thailand, but only a relatively small percentage of women follow this screening program. An alternative method to detect HPV genotypes associated with cervical cancer is self-sampling of urine, which is a more widely accepted method. Our study aimed to evaluate the prevalence of HPV in Thai women using urine and cervical swabs and prevalence of HPV in Thai men using urine samples. Materials and Methods: Tumorigenic HPV detection was accomplished by electrochemical DNA chip and PCR/direct sequencing. In addition to HPV prevalence, we report the concordance between different methods and sample types. One-hundred and sixteen women and 100 men were recruited. Histological examination revealed normal cytology in 52 women, atypical squamous cells of undetermined significance (ASCUS) in 9, low-grade squamous intraepithelial lesions (LSIL) in 24, and high-grade squamous intraepithelial lesions (HSIL) in 31. One-hundred men were classified as heterosexuals (n=45) and homosexuals (n=55). Results: The most prevalent HPV genotype in our study was HPV16. The HPV detection rate was generally lower in urine samples compared with cervical samples. Overall, there was good agreement for the detection of carcinogenic HPV from female cervical samples between the DNA chip and PCR/sequencing, with 88.8% total agreement and a kappa value of 0.76. In male urine samples, the level of agreement was higher in heterosexuals compared with homosexuals. Conclusions: Further improvement is required to increase an overall yield of HPV DNA detection in urine samples before clinical application of a urine-based HPV screening program. The electrochemical DNA chip test is a promising technique for carcinogenic HPV detection.

Cervical Cancer Prevention for the Future: the Complimentary Roles of Cytology Screening and HPV Vaccination (자궁경부암 예방의 미래 : 세포선별검사와 HPV 예방접종의 역할)

  • McGoogan, Euphemia
    • The Korean Journal of Cytopathology
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    • v.18 no.1
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    • pp.1-12
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    • 2007
  • Approximately 70% of cervical cancers are caused by HPV types 16/18 and thus the implementation of vaccination programmes with vaccines against HPV types 16/18 will have a major impact on the incidence of cervical cancer worldwide. However, this reduction will not be seen until several decades after full implementation of such vaccination programmes since the vaccines must be given to young adolescents before exposure to the virus and women who are already sexually active are not likely to be protected. Both GSK and Merck insist that even vaccinated women must continue to participate in regular cervical screening by the most sensitive method available since the vaccine can only give protection against up to 70% of cervical cancers. It is unlikely that the current vaccines will be modified to include additional high risk HPV types in the foreseeable future. While HPV testing is highly sensitive, it is not recommended for women under 30 years of age nor for vaccinated women. Additionally, HPV testing has poor specificity. The Digene Hybrid Capture 2 test is licensed for use only in conjunction with a cytology test, not as a stand-alone test, and the high risk panel has recognised cross reactivity with low risk HPV types. None of the other HPV test methods currently commercially available are FDA approved and all must be internally validated before use. This makes comparison of test results between laboratories difficult. The most sensitive and specific screening test currently available for women of all ages is the Cytyc ThinPrep System consisting of the ThinPrep Pap Test (TPPT) and the ThinPrep Imaging System (Imager). The TPPT was the first LBC system approved by the US FDA in 1996 and there are about 4,000 processors in use worldwide. The Imager was FDA approved in 2003 and over 350 systems are in routine use, mainly in the US. 40% of TPPT in the US are processed on Imager. There is clear evidence in peer reviewed literature that the Imager increases laboratory productivity by 100% and growing evidence that Imager detects more high grade SIL than the conventional smear or manual evaluation of TPPT. This aspect is particularly important since the number of cytological abnormalities will decrease as vaccination programmes are implemented. Cytotechnologists will see fewer and fewer abnormal smears and their skills will be put at risk. By doubling throughput, Imager will allow cytotechnologists to maintain their skills.

Immunocytochemical Study on the Enteroendocrine Cells in the Gastrointestinal Tracts of the Korean Snakes (한국산 뱀목 위장관 점막이 장내분비세포에 대한 면역세포화학적 연구)

  • 진원주;조운복;최월봉
    • The Korean Journal of Zoology
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    • v.33 no.3
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    • pp.276-296
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    • 1990
  • This study attempts to investigate several enteroendocrine cells in the gastrointestinal epithelia of the Korean snakes (Dinodon rufozonatum rufozonotum Rhabdophis tigrina tigrina, Enhydris rufodorsata, Agkistrodon blomhoffii brevicaudus, Agkistrodon saxatilis, Agkistodon calginosus). For a light-microscopical examination of immunocytochemistry, the paraffin sections (5 $\mu$ m) of tissue specimens taken from the various parts of the gastrointestinal tract were stained immunocytochemically by PAP procedure with 10 antisera. The frequency of enteroendocrine cells per unit area (mm$^2$) of each mucosa were counted and the shapes of the cells were observed. In Dinodon rufozonatum rufozonatum, Rhobdophis tigrina tigrina, Enhydris rufodorsata, Agkistrodon saxatilis and Agkistrodon caliginosus, cholecystokinin (CCK)-8, gastrin, pancreatic polypeptide (PP) and serotonin cells were observed. But the freuqency of these immunoreactive cells differ trom each portion of gastrointestinal tracts of all species, respectively. In Agkistrodon blomhoffii brevicaudus, CCK-8, gastrin and serotonin cells were observed. CCK-8 and serotonin cells were found in whole gastrointestinal tracts and gastrin cells were observed in pylorus and mucosa of small intestine. The frequency of these cells was different from each portion. The shapes of CCK-8, gastrin, PP and serotonin cells were pyramidal or oval and closed type in stomach. A large number of these cells were spindle in shape and open type in small intestine and anterior pant of large intestine, whereas some cells were closed type. In posterior part of large intestine and rectum, these cells were oval in shape and closed type.

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Comparative seed morphology of the tribe Alsineae (Caryophyllaceae) in Korea and its taxonomic implications (한국산 Alsineae (석죽과) 종자의 형태비교 및 분류학적 유용성)

  • Song, Jun-Ho;Kim, Ju-Mi;Ok, Min-Kyoung;Hong, Suk-Pyo
    • Korean Journal of Plant Taxonomy
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    • v.45 no.4
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    • pp.369-379
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    • 2015
  • The seed morphology of 25 taxa (8 genera) of Alsineae (Alsinoideae, Caryophyllaceae) in Korea was examined using stereo (SM) and scanning electron microscopy (SEM) in order to evaluate their diagnostic values and taxonomic implications. Circular, comma-shaped, ellipsoid, ovate, pyriform, reniform, and sub-circular seed shapes were identified. The seeds of the examined taxa range from 0.28 to 4.10 mm in length and from 0.33 to 3.10 mm in width; the smallest one was found in Sagina japonica, while the largest was in Honkenya peploides var. major. A hilar appendage was found in Cerastium, Honkenya, Moehringia, and strophioles were only observed in the genus Moehringia. Based on the examination of epidermal cells of the seed surface, four micromorphological types can be distinguished, viz., the colliculate-papillate (Col-Pap), colliculate-columellate (Col-Cll), colliculate-simple (Col-Sim), and smooth (Sm) types. Descriptions of the testa shape, margin, and the degree of elevation of the anticlinal cell walls, and the outer periclinal cell walls are summarized for the tribe. Taxonomic implications of the seed micromorphological characters were also discussed, in comparison with an earlier taxonomic system.

Hemodynamic Evaluation of Acute Mitral Valve Insufficiency Model induced by Chordae Tendinae Rupture in Normal Dogs (개에서 건삭파열로 유발한 급성 이첨판 폐쇄부전 모델의 혈류역학적 평가)

  • Kim, Sehoon;Kim, Nam-Soo;Lee, Ki-Chang;Kim, Jong Min;Kim, Min-Su
    • Journal of Veterinary Clinics
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    • v.31 no.5
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    • pp.367-370
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    • 2014
  • The study was to observe hemodynamic alterations of cardiac function to design a model of canine mitral valve insufficiency (MVI) based on chordae tendinae rupture (CTR). Ten healthy beagles with normal heart function were used in this study. To measure hemodynamics, the patient monitor was equipped for invasive blood pressure and a Swan-Ganz catheter. Hemodynamic alterations were checked promptly during CTR procedures. MVI model was made by transection of the chordae tendinae with small arthroscopy hook knife through $5^{th}$ intercostal open chest. Color Doppler at the level of the mitral valve showed high-velocity regurgitant flow immediately after CTR at intraoperative echocardiography. In hemodynamic measurements, pulmonary capillary wedge pressure (PCWP) was significantly increased, while mean arterial pressure (MAP), venous pressure (VP), pulmonary arterial pressure (PAP), cardiac output (CO) and cardiac index (CI) were significantly decreased after CTR. It was known that the left atrium was overloaded by regurgitant volume from the left ventricle. In conclusion, the MVI model induced by CTR technique in this study should be used as suitable one for the effective research of canine mitral valve disease. Further study should be needed to measure the chronic alternation of mitral valve in the model.

A Case of Obstructive Sleep Apnea Syndrome in Childhood (소아 폐쇄성 수면무호흡증후군 1례)

  • Lee, Seung-Hoon;Kwon, Soon-Young;Lee, Sang-Hag;Chang, Ji-Won;Kim, Jin-Kwan;Shin, Chol
    • Sleep Medicine and Psychophysiology
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    • v.11 no.1
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    • pp.50-54
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    • 2004
  • The obstructive sleep apnea syndrome can occur due to various etiologies in children. In otherwise healthy children, adenotonsillar hypertrophy is the leading cause of childhood obstuctive sleep apnea. Obstructive sleep apnea caused by adenotonsillar hypertrophy can lead to a variety of symptoms and sequelae such as behavioral disturbance, enuresis, failure to thrive, developmental delay, cor pulmonale, and hypertension. So if obstructive sleep apnea is clinically suspected, proper treatment should be administered to the patient after diagnostic examinations. More than 80% improvement is seen in symptoms of obstructive sleep apnea caused by adenotonsillar hypertrophy in children after tonsillectomy and adenoidectomy. However, when it is impossible to treat the patient using surgical methods or residual symptoms remained after tonsillectomy and adenoidectomy, additional treatments such as weight control, sleep position change, and continuous positive airway pressure (CPAP), should be considered. This paper reports a case using weight control and Auto-PAP to control mild sleep apnea and snoring, which in long-term follow-up were not resolved after tonsillectomy and adenoidectomy for severe obstructive sleep apnea.

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The effect of trypsin and chymotrypsin on the chemotaxis and activation of eosinophil (Trypsin과 chymotrypsin이 호산구 화학주성 및 활성화에 미치는 효과)

  • Lee, Myung-Goo;Kim, Myung-Bin;Kim, Jin-Hwan;Yun, Taek Joong;Choi, Jeong-Eun;Kim, Dong-Hwan;Mo, Eun-Kyung;Park, Myung-Jae;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.359-366
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    • 1996
  • Background : Eosinophilic leukocytes are prominent cellular participants in the pathogenesis of allergic disease and asthma. Chemotaxis is still a very useful method in evaluating the response of human eosinophil to novel modulators. Degranulated mast cells and activated T lymphocytes are responsible for the pathophysiology of asthma and tryptase is one of most important proteases released after activation of mast cells. The purpose of this study was to investigate the actions of trypsin and chymotrypsin on eosinophils in terms of chemotaxis and activation. Method : Eosinophils were isolated by negative immunoselection from the peripheral blood of atopic donors. Chemotaxis was studied by using micro-Boyden chambers and ECP release was assayed by fluoroimmunoassay. Results : Eosinophil showed a chemotactic response to trypsin. Maximal chemotactic response was with $1000{\mu}g/ml$ trypsin ($56.52{\pm}14.50$/HPF) which was comparable to PAP. But chymotrypsin showed no significant chemotactic response to eosinophils. Trypsin at the concentration of 10, 100, $1000{\mu}g/ml$ induced secretion of ECP, which at the concentration of $10{\mu}g/ml$ represented about 2.7 times of the spontaneous rate of release. Soybean protease inhibitor reduced trypsin induced ECP release. Conclusion : Trypsin can induce chemotactic response to eosinophils and activation of eosinophils that can induce secretion of ECP. On the contrary, chymotrypsin showed no direct effect on eosinophils. We propose a role of trypsin on the chemotaxis and activation of eosinophils.

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The effects of the 16-weeks' combined exercise program on metabolic syndrome and autonomic nerve system of low-level physical strength group (16주 복합운동프로그램을 통한 저체력군 고등학생의 대사증후군 지표와 자율신경계의 변화)

  • Han, Jin-Man;Lee, Kyeong-Jun;Yang, Jeong-Ok
    • Journal of the Korean Data and Information Science Society
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    • v.23 no.4
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    • pp.787-796
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    • 2012
  • The aim of this study is to closely examine the changes in their metabolic syndrome index and autonomic nerve systems after the 16-weeks's combined exercise program is carried out on low-level physical strength group (PAPS 4-5 level students). They were divided into two groups; exercise training group (15) and control group (15). This program consisted of five-times-a-week's warm-ups, main activities and warm-downs and it takes 50 minutes per trial. Through SPSS 19.0, all averages and standard deviations of dependent variables were calculated. We first performed Shapiro-Wilk's normality test of the variables. Before verifying the effect of combined exercise program, we tested the equality of means of the variables between combined-exercise-programmed-group and control group through a two-sample t-test and carried out a paired t-test to check if the changes in the variables of two groups before and after 16 weeks are statistically significant. Every statistical test is performed at a significance level of ${\alpha}$=.05. The results are as follows. When it came to metabolic syndrome index, there were statistically meaningful changes in waist measurement, triglyceride, glucose with empty stomach and HDL-C. Also, when it came to autonomic nerve system, there were meaningful changes in all variables. Consequently, it seems that the 16-weeks combined exercise program has positive effects on low level physical strength students.