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Background@#Nucleic acid sequencing is a multi-step process taken place in medical research or diagnostic laboratories. Since the emerge of second generation sequencing technology generally referred as next generation sequencing (NGS), the mass parallel reads covering human genome or transcriptome is achieved by cost cut down over thousand folds. Though the technology made tremendous push forward to various applications, its data analysis time and effort still takes worrisome time and human effort, bringing the emerge of next-step demand: targeted mass sequencing of only desired part from human genome or transcriptome with lower material cost and labor. By targeted sequencing, both run cost and data analysis process can be further cut down, and the read results are more reliable on changes such as determining varied number of repeats, heterozygote alleles, deletions, chromosomal scale abnormality and more. @*Objective@#In this study, we explored the utilization of biotinylated RNA baits on captured sequencing of cancer marker genes functional regions.@*Method@#Targeted NGS was achieved by capturing desired genomic regions using preparatory nucleic acid probes. RNA bait capturing of desired genomic regions has shown to have high specificity and quality. </br> The study was carried out with informed consent obtained from patients, with the approval №53 in 2018.03.15 by Medical Ethics committee, Ministry of Health, Mongolia.@*Result@#By preparing library of biotinylated RNA baits with 75000 unique sequences, we achieved mass parallel sequencing of human 410 cancer-marker-genes’ exons and UTRs with average read depth ~760, and covered thousands of SNPs on 5 genomic DNA samples. Tissue samples derived from breast cancer and ovary cancer had SNP and deletion on 7 marker genes (BRCA1, BRCA2, ATM, BRIP1, PTEN, TP53, RAD51C) not registered in database.@*Conclusion@#Experiments showed RNA baits with up to 117 nucleotide length, produced from ssDNA oligonucleotide stock, can be utilized to capture desired regions of human genome, and bring the cost of captured mass sequencing to 1500 USD, with 93.14-93.33% of Q30 read quality.
ABSTRACT
Introduction: Hysterectomy is second mostfrequent gynecological operation. Historicallythe uterus has been removed by either theabdominal or vaginal route. The vaginaloperation is preferable when there are nocontraindications because of lower morbidityand quicker recovery. Since it was first reportedby Reich et al in 1989 laparoscopically assistedvaginal hysterectomy (LAVH) has gainedwidespread acceptance. To compare totallaparoscopic hysterectomy (TLH), laparoscopicassistedvaginal hysterectomy(LAVH), vaginalhysterectomy (VH) and total abdominalhysterectomy(TAH).Materials and methods: A prospective,randomized study was performed atGynecologic Surgery Department of NationalCancer Center of Mongolia between March2013 and January 2014. A total of 120 womenindicated to undergo hysterectomy for cervixcancer stage 0-1, uterine myoma, uterinecancer were randomly assigned to fourdifferent groups (30 VH, 30 LAVH,30 TLH and30 TAH). Operating time, blood loss, rate ofcomplications, consumption of analgesics andlength of hospital stay were measured in eachgroup.Results: In our research the groups weresignificantly different for mean intraoperativeblood loss were TLH:119+/-54.7mL, LAVH:127.5+/-52.7 mL, VH; 145+/-57.8 mL andTAH: 210+/-77.4mL (P=.007) and operativetime were TLH 115+/-16.6 minutes LAVH:112.5 +/-18.5 minutes; VH: 51.6 +/-16.9minutes;TAH:69+/-18.2 (P = .001). Theaverage weight of uterine were from 95.1+/-27.6mg (range 58-140) in the VH group ,to 181.2+/-97 (range 76-400g) in the LAVHgroup through to 122.3+/-64 for the TAHgroup. Postoperative pain on day 0 and thetotal abdominal group were 5.5+/-0.7 days ofanalgesic request it was higher than other threegroups (TLH: 3.0+/-0.8days, LAVH: 3.08+/-0.7days, VH: 3.0+/-0.86 days P<.001). LAVHwas associated with a reduced hospital stay(TLH: 3.3+/- 0.7, LAVH: 3.3 +/- 0.6 days;VH: 3.7 +/- 0.6 days;TAH:6.5+/-0.7 P <.001). Total Laparoscopic hysterectomy hadlongest operating time (115+/- 16.6min), a lowcomplication rate, lack of severe post-operativecomplications. Vaginal hysterectomy had theshortest operating time (51.6+/-16.9min).However, there were technical problems withsalpingo-oophorectomy from the vaginalapproach and this group had a significantlyhigher rate of febrile complications (20%)compared to LAVH (2.3%) and TAH (16%).Conclusion: Even though operative timefor VH is less than TLH, there is a technical problem known as salpingo-oophorectomy.TLH and LAVH have number of advantagesincluding less interaoperative blood lose, lesspostoperative analgesic requirement, andshorter duration of postoperative hospitalstays.
ABSTRACT
BACKGROUND: Hysterectomy is second most frequent gynecological operation. Historically the uterushas been removed by either the abdominal or vaginal route. The vaginal operation is preferablewhen there are no contraindications because of lower morbidity and quicker recovery. Since it wasfirst reported by Reich et al in 1989 laparoscopically assisted vaginal hysterectomy (LAVH) hasgained widespread acceptance.OBJECTIVES: To compare the outcome measures which including operating time, blood loss, rateof complications, consumption of analgesics, and length of hospital stay of total laparoscopichysterectomy (TLH), laparoscopic-assisted vaginal hysterectomy(LAVH), vaginal hysterectomy(VH) and total abdominal hysterectomy(TAH).METHODS: A prospective, randomized study was performed at Gynecologic Surgery Department ofNational Cancer Center of Mongolia between March 2013 and January 2014. A total of 110 womenindicated to undergo hysterectomy for cervix cancer stage 0-1, uterine myoma, and uterine cancerwere randomly assigned to four different groups (30 VH, 30 LAVH, 20 TLH and 30 TAH).RESULTS: In our research the groups were significantly different for mean intraoperative blood losswere TLH: 119+/-54.7mL, LAVH: 127.5+/-52.7 mL, VH; 145+/-57.8 mL and TAH: 210+/-77.4mL(P=.007) and operative time were TLH 115+/-16.6 minutes LAVH: 112.5 +/-18.5 minutes; VH:51.6 +/-16.9 minutes; TAH: 69+/-18.2 (P = .001). The average weight of uterine were from 95.1+/-27.6mg (range 58-140) in the VH group, to 181.2+/-97 (range 76-400g) in the LAVH group throughto 122.3+/-64 for the TAH group. Postoperative pain on day 0 and the total abdominal group were5.5+/-0.7 days of analgesic request it was higher than other three groups (TLH: 3.0+/-0.8days,LAVH: 3.08+/-0.7days, VH: 3.0+/-0.86days P <.001). LAVH was associated with a reduced hospitalstay (TLH: 3.3+/- 0.7, LAVH: 3.3 +/- 0.6 days; VH: 3.7 +/- 0.6 days;TAH:6.5+/-0.7 P < .001). TotalLaparoscopic hysterectomy had longest operating time (115+/- 16.6min), a low complication rate,lack of severe post-operative complications. Vaginal hysterectomy had the shortest operatingtime (51.6+/-16.9min). However, there were technical problems with salpingo-oophorectomy fromthe vaginal approach and this group had a significantly higher rate of febrile complications (20%)compared to LAVH (2.3%) and TAH (16%).CONCLUSION: However TLH, LAVH and VH seem to be operative time, blood loss and hospitalstay, VH were technical problem salpingo-oopheretomy. TLH and the LAVH has advantages overthe TAH in that in the former there is less intraoperative blood loss, less postoperative analgesicrequirement, and a shorter duration of postoperative hospital stays.
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Background: Cervical cancer is the most common cancer in female reproductive system. Since introduction of diagnostic modalities like Pap-tests, the detection pre-cancerous cervical lesions CIN1, CIN2 and CIN3 have increased dramatically. Early detection of pre-cancerous lesions enables performance of organ sparing treatments like LEEP, conization and cryotherapy.Aim: Since there are no studies in the field of organ sparing treatment of cervical cancer, we decided analyze the results of such treatments and calculate the:1. Five year survival of patients underwent organ sparing surgical procedures2. Fertility and reproductive function of these patientsMethod: LEEP (n-63), knife conization (n-22) and trachelectomy (total removal of cervix) (n-15) was performed in women of reproductive age (25-35 years old) at National Cancer Center. The treatment results were followed for 5 years and statistical analysis of survival and reproductive function were analyzed.Results: 87.7% of patients with CINI lesions had LEEP, 12.3 % had knife conization and 0% had trachelectomy. 44.4% of patients with CINI lesions had LEEP, 55.6 % had knife conization and 0% had trachelectomies respectively. For CINIII 6.2% of patients had LEEP, 0% had knife conization and 93% had trachelectomy.We performed organ sparing treatment in 100 patients, out of which 10% had cancer recurrence in LEEP treatment, 9.1% in knife conization and 0% in trachelectomy. Complications of hemorrhage were observed in 14% of patients, cervical tube obstruction in 3% and deterioration of chronic inflammations in 13% respectively. After the organ sparing treatment, menstrual cycle was normal in 75% of the all patients, 65% reached pregnancy. 9.2% of patients who reached pregnancy had stillbirth, 12.3% had abortion, and 78.5% had normal delivery. 80.4% of patients with pregnancy had natural labors, while19.6% of patients had ceasarean sections respectively. Conclusion: in Mongolia, LEEP, knife conization and trachelectomy methods are used since 2000. But the treatment results were not reported so far. 10% of patients treated by LEEP and 9.1% of patients treated by knife conization had tumor recurrence. Thus our treatment efficiency is above 90%. Up to 20% of patients had complications ranging from bleeding to cervical tube obstruction. We conclude that organ sparing cancer treatment allows better QOL (quality of life) for the patients and provides opportunity to have children.