ABSTRACT
Objective: To study the effect of serum from patients with atherosclerotic risk factors on the synthesis of endothelial tissue factor. Methods: Serum from 30 diabetic patients, 30 hyperlipemic patients, 30 smokers and 30 normal serum were incubated with cultured endothelial cells from a human umbilical vein. The tissue factor of endothelial cells was measured using the assay that was developed in house after 24 hours incubation time. Results: Smokers’ serum can significantly cause the increase in endothelial tissue factor. The mean level of tissue factor induced by smokers’ serum is 1.12 microunits/cell whereas the mean level of tissue factor induced by diabetic serum, hyperlipemic serum and normal serum is 0.4, 0.48 and 0.2 microunit/cell, respectively. Conclusion: Smoking may increase the risk of thrombosis by increasing the tissue factor production of endothelial cells.
ABSTRACT
This study aimed to evaluate the correlation and agreement between Siriraj liquid-based cervical cytology (Siriraj -LBC) and conventional cytology. A total of 479 women who attended the Department of Obstetric and Gynaecology Siriraj Hospital for cervical cancer screening were enrolled. For each woman collection of cervical cells was performed using VCE technique. After smearing cells on a glass slide for conventional cytology, both broken ends of wooden spatula and cotton swabs were then placed into a plastic vial containing a specific preservative solution for Siriraj-LBC. All specimens were prepared and interpreted by experienced cytotechnologists at the Gynecologic Cytology Unit. Interpretations of the results from one technique were made without knowledge of those from the other technique. The results from both techniques were compared for agreement and correlation. Colposcopy or histology was used as the gold standard. The overall detection rate of abnormal cervicovaginal cells was higher by Siriraj-LBC than by conventional cytology (11.1% vs. 1.67%, P <0.001). These two techniques had high diagnostic agreement of 89.77%, and minimal to fair correlation with a Kappa of 0.128 (P<0.001) and a Spearman rho correlation coefficient of 0.394 (P <0.001). There were 49 cases whose Siriraj-LBC revealed higher cytologic grading than did the conventional cytology; there were no cases of the opposite result. The gold standard was available in 45 cases with abnormal cytology by Siriraj-LBC, revealing a positive predictive value (PPV) of 71.1% for Siriraj-LBC and 97.8% for conventional cytology, and a negative predictive value (NPV) of 42.2% for the conventional cytology. In conclusion, The results from Siriraj-LBC and conventional cytology have high diagnostic agreement and minimal to fair correlation. The Siriraj-LBC increases detection rate of abnormal cervicovaginal cells with probable decrease in false negatives but increase in false positives from the baseline values by conventional cytology. Therefore the screening performance of Siriraj-LBC is not inferior to the conventional cytology and this approach may be used as an alternative screening method for cervical cancer.
ABSTRACT
Over a 5-year period, 402 women with benign cystic teratoma of the ovaries were seen at Siriraj Hospital. Fifty patients had bilateral ovarian tumors (12.44%). In 47 of these patients, bilateral involvement was evident on clinical examination. One hundred and seventy three patients with a visually normal opposite ovary had 3 (1.16%) identifiable tumors in that ovary by incidental ovarian operations. This 1.16% incidence of occult covert bilaterally is quite low and suggests that routine bivalving of wedge resection of a clinically normal opposite ovary is not necessary since peri-tubo-ovarian adhesion, pain and adhesion, pain and infertility are the common result. However, the possibility of such an occult tumor is not zero.
ABSTRACT
A retrospective study was done on 120 patients with atypical cells in Papanicolaou smears obtained during a five-year period (1982-1986) at the Cytology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University. The patients were divided into three groups according to diagnostic procedures. Each group consisted of 44, 46 and 30 patients respectively. Group I had normal cervices on examination and were referred for colposcopy. Group II had suspicious cervices, and biopsies were done on grossly visible lesions. Group III had histories of abnormal uterine bleeding and underwent diagnostic fractional curettages. Of group I, 11 (25%) were found to have CIN 1-3 and 4 (9.1%) had invasive carcinoma. Of group II, 4 (8.7%) were found to have CIN 2-3, 13 (28.3%) had invasive carcinoma. Of group III, 12 (40%) were found to have endometrial hyperplasia and 6 (20%) had endometrial carcinoma. It appears that a Papanicolaou smear report of atypical cells should be considered abnormal, further evaluation is required according to the clinical presentation of the patient.