Genetic analysis using the fluorescence in situ hybridization (FISH) method applied to intact tissue sections of formalin-fixed paraffin embedded (FFPE) tissue is well known to be relatively difficult. The frequent technical problems include unsuccessful hybridization as a result of poor probe penetration, excessive probe requirement, excessive background, auto-fluorescence, and overlapping or incomplete nuclei. These problems lead to absence or insufficiency of fluorescent signals, resulting in an inaccurate analysis. Formalin-fixed paraffin embedded tissue can be analyzed either as intact tissue sections or as a suspension of disaggregated, but intact, nuclei. Intact tissue sections have the advantage of preserved tissue architecture and morphology but have the intrinsic disadvantage of poor probe penetration, overlapping or incomplete nuclei and auto-fluorescence, accordingly reducing the accuracy of fluorescent signals evaluation.To present the effective FISH method applied to isolated of single nuclei and the procedures for isolation of a single nuclei from formalin-fixed paraffin embedded tissues of hepatocellular carcinoma.Ten paraffin-embedded blocks of hepatocellular carcinoma tissues from the department of pathology, Ramathibodi hospital, Thailand were studied. Isolated single nuclei were extracted from 10-microm sections of paraffin-embedded blocks of hepatocellular carcinoma tissue and hybridized with alpha-satellite centromeric DNA enumeration probes for chromosomes X (CEP X, spectrum green) and satellite III for chromosomes Y (CEP Y spectrum orange). The signal of at least, 200 interphase nuclei were counted from each specimen.The efficacy of this method has been evaluated in 10 formalin-fixed paraffin embedded tissue of hepatocellular carcinoma. The results showed bright, planar and an easy to score signal.FISH procedure described here is particularly suitable for retrospective studies of genetic aberration applied to formalin-fixed paraffin embedded tissues.
A case of hepatocellular adenoma (HCA) was described in a 26-year-old woman, who was a potential kidney donor for her father and denied taking the oral contraceptive pill. A hypervascular mass of 4.1 cm in largest dimension was detected in the liver segment V by computerized tomography and magnetic resonance imaging (MRI). The normal levels of liver enzymes, negative serum markers for hepatitis viruses, and non-elevated alpha- fetoprotein level were detected. The wedge resection of segment V was done with an uneventful clinical course. In Western countries, HCAs are known to occur in women in their reproductive periods. It may not be associated with oral contraceptive. Molecular biological studies disclosed three variants of HCAs, i.e., I) with mutation of HNF 1-alpha gene, II) with mutation of beta-catenin gene, and III) no mutation of the two genes. Histological correlations with the three variants as recommended by the Bordeaux group in 2007 could not be accomplished in the present study due to overlapping histological features between the variants I and III. The etiological factors of HCA are known to relate to the contraceptive pill usage in female and the anabolic-androgenic-steroid administration in male. In Thailand, the occurrence of HCA is expected to be only 0.3% of cases with hepatocellular carcinoma.
Backgrounds: Pelvic cancer surgery has a high risk for venous thromboembolism (VTE). Pharmacologic venous thromboprophylaxis is not routinely accepted among surgical practice in Thailand due to the awareness of major bleeding complication. However, ACCP guideline recommends mechanical prophylaxis to be initially used in this condition and pharmacologic prophylaxis is subsequently administered during postoperative period with minimal risk of bleeding. Therefore, it was possible to evaluate the efficacy of VTE prophylaxis in pelvic cancer surgery among our population. Objective: To evaluate the efficacy and safety of VTE prophylaxis in pelvic cancer surgery. Material and Method: Patients with pelvic cancer including gynecologic cancer and urologic cancer to undergo surgery were enrolled in the present study. The patients with colorectal cancer were excluded from the present study due to their declination. The present study randomized the patients into 2 groups regarding the receiving VTE prophylaxis. In prophylaxis group, intermittent pneumatic compression (IPC) was initially applied at intraoperative period and at least 3 days postoperatively until full ambulation. During the minimal risk of postoperative bleeding in this group, Enoxaparin (0.4 ml subcutaneous daily) was administered for 4 weeks. In control group, there was no VTE prophylaxis. Assessment of VTE was carried out at the 2 nd and 5 th week after surgery. Postoperatively, diagnosis of deep vein thrombosis (DVT) was performed by duplex ultrasonography and diagnosis of pulmonary embolism (PE) was initially done by clinical manifestations and then confirmed by computed tomographic angiography of pulmonary artery. Results: A total of 108 pelvic cancer patients including 70 patients with gynecologic cancer and 38 patients with urologic cancer. The prevalence of proximal DVT after pelvic cancer surgery in the present study was 2.8%, which were 3.7% in control group and 1.8% in prophylaxis group ( p = 1.000). The relative risk reduction was 50%. In gynecologic cancer patients, prevalence of postoperative proximal DVT was 6.5% in control group and 2.6% in prophylaxis group ( p = 0.580). The relative risk reduction was 60%. There was no postoperative proximal DVT in urologic patients. Postoperative symptomatic PE was not found in this study. Bleeding complications was 3.7% (1.8% major bleeding and 1.8% minor bleeding) in prophylaxis group compared with 0% in control group ( p = 0.495). Conclusion: After the implementation of VTE prophylaxis in pelvic cancer surgery, the prevalence of postoperative proximal DVT was decreased with significant risk reduction in gynecologic cancer surgery and the risk of postoperative bleeding was acceptable. VTE prophylaxis program may be benefit in gynecologic cancer surgery in Thai population. Keywords: Venous thromboembolism, cancer surgery, DVT prophylaxis, VTE prophylaxis, deep vein thrombosis, pulmonary embolism
Our understanding of the biology of malaria parasite liver stages is limited because of the lack of efficient in vitro systems that support the exo-erythrocytic (EE) development of the parasite. We report the development of a new hepatocyte line (HC-04) from normal human liver cells. The HC-04 cells have proliferated in hormone-free medium for more than 200 passages. The cells were hyperdiploid, resembled liver parenchymal cells, and synthesized major liver-specific proteins and enzymes. Using Plasmodium falciparum and P. vivax sporozoites harvested from salivary glands of infected mosquitoes, we showed that HC-04 cells supported the complete EE development of these two most prevalent human malaria parasites. The EE parasites attained full maturation as shown by their infectivity to human erythrocytes. The infection rates of the liver cells were estimated to be 0.066% and 0.041% for P. falciparum and P. vivax, respectively. As the first human hepatocyte line known to support complete EE development of both P. falciparum and P. vivax, HC-04 will provide an experimental model that can be used for studying the biology of liver stage malaria parasites.
Transplant renal artery stenosis (TRAS) is one of the common vascular complications post kidney transplantation. A retrospective study of TRAS among transplant recipients at a single transplant center in Thailand was performed from February 1986 to December 2002. Among 750 cases, 16 cases (2.1%) of TRAS were identified. Twelve cases (3.3%) were from cadaveric donors and four cases (1%) were from living-related donors (p-value = 0.034). Most cases presented with progressive deterioration of kidney graft with or without refractory hypertension. Doppler ultrasonography was used for initial screening followed by renal angiography. Fifteen cases were treated by Percutaneous Transluminal Angioplasty (PTA) with a 73 per cent success rate. Five cases underwent surgical revascularization with an 80 per cent success rate. Two cases (13%) of successful PTA showed recurrent stenosis with 46 months follow-up which were successfully treated by repeated PTA with stents.
'%3e%3cpath fill='%23012169' d='M0 0v30h60V0z'/%3e%3cpath stroke='%23fff' stroke-width='6' d='m0 0 60 30m0-30L0 30'/%3e%3cpath stroke='%23C8102E' stroke-width='4' d='m0 0 60 30m0-30L0 30' clip-path='url(%23b)'/%3e%3cpath stroke='%23fff' stroke-width='10' d='M30 0v30M0 15h60'/%3e%3cpath stroke='%23C8102E' stroke-width='6' d='M30 0v30M0 15h60'/%3e%3c/g%3e%3c/svg%3e)
