Tissue factor expression of endothelial cell in response to atherosclerotic risk factors.

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.

Comparison between Siriraj liquid-based and conventional cytology for detection of abnormal cervicovaginal smears: a split-sample study.

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.

A comparison study between oral morphine syrup and morphine intramuscular injection in premedication.

A randomized single blind clinical trial was carried out in order to compare the effectiveness of oral morphine syrup and injected morphine in premedication of postpartum tubal sterilization by local anaesthesia. A total of 200 postpartum patients were divided into two groups by systemic random sampling. The first group of 100 patients was premedicated with 30 mgs of syrup morphine orally 90 minutes before operation, and the second group of 100 patients was premedicated with 10 mgs of morphine hydrochloride via the intramuscular route 15 minutes before operation. All patients were given tubal sterilization by first- and second- year residents, using the modified Pomeroy technique. The pain experienced by each patient during the operation was evaluated by verbal and numerical rating scales. The pain scores and the operating time of both groups were analysed by the Mann Whitney U test and pair t test, respectively. The pain scores of the first and second group were 3.644 + 1.802 and 3.570 + 1.470, respectively, with no significant difference. The operating time was 10.300 + 1.904 and 11.200+ 2.543 minutes in the first and second group, respectively. The effectiveness of oral morphine syrup and intramuscular morphine in premedication for postpartum tubal sterilization was found to give the same results. The cost-effectiveness of oral morphine syrup is greater and it can therefore replace intramuscular morphine in premedication for postpartum tubal sterilization.

Effect of endothelial cells from babies born to pre-eclamptic mothers on tissue factor activity of normal endothelial cells.

A technique to measure the tissue factor activity of endothelial cells was developed and the tissue factor activity of the endothelial cells was studied after stimulation with cultured media from the endothelial cells of babies born to severe per-eclampsia patients and from normal pregnancies. The results show no statistical differences. Media from the endothelial cells of the babies of pre-eclampsia patients induced the tissue factor activity to a mean level of 0.08 mU/ml, whereas that from the normal pregnancies stimulated the tissue factor synthesis to a mean level of 0.14 mU/ml. It may be concluded that there are no injurious substances released from the endothelial cells of babies that cause increased tissue factor synthesis from endothelial cells.