Rapid Staining Using the Shorr Method for Intraoperative Peritoneal Washing Cytology in Advanced Gastric Cancer: a Pilot Study from a Single Institution

PURPOSE: Intraoperative peritoneal washing cytology (PWC) is used to determine treatment strategies for gastric cancer with suspected serosal invasion. However, a standard staining method for intraoperative PWC remains to be established. We evaluated the feasibility of a rapid and simple staining method using Shorr's stain for intraoperative PWC in advanced gastric cancer. MATERIALS AND METHODS: Between November 2012 and December 2014, 77 patients with clinical T3 or higher gastric cancer were enrolled. The sensitivity, specificity, and concordance between the Shorr staining method and conventional Papanicolaou (Pap) staining with carcinoembryonic antigen (CEA) immunohistochemistry (IHC) were analyzed. RESULTS: Intraoperative PWC was performed laparoscopically in 69 patients (89.6%). The average time of the procedure was 8.3 minutes, and the average amount of aspirated fluids was 83.3 mL. The average time for Shorr staining and pathologic review was 21.0 minutes. Of the 77 patients, 16 (20.7%) had positive cytology and 7 (9.1%) showed atypical findings; sensitivity and specificity were 73.6% and 98.2% for the Shorr method, and 78.9% and 98.2% for the Pap method with CEA IHC, respectively. Concordance of diagnosis between the 2 methods was observed in 90.9% of cases (weighted κ statistic=0.875) and most disagreements in diagnoses occurred in atypical findings (6/7). In overall survival, there was no significant difference in C-index between the 2 methods (0.459 in Shorr method vs. 0.458 in Pap with CEA IHC method, P=0.987). CONCLUSIONS: Shorr staining could be a rapid and reliable method for intraoperative PWC in advanced gastric cancer.

Effects of Treatment According to Tattoo Color, Site and Duration with the Q-Switched Alexandrite Laser / 대한피부과학회지

BACKGROUND: After the development of the Q-switched lasers, it was possible to remove tattoos without causing scarring. Currently, Q-switched ruby lasers, Q-switched Nd: YAG lasers and Q-switched alexandrite lasers are used selectively to treat tattoos. The objective of this study was to determine the difference of effectiveness aceording to color, site and duration in removing tattoo pigments by the alexandrite laser. MATERIALS AND METHODS: 30 tattoos were treated with a Q-switched alexandrite laser(model IL-l, Candela Laser Corporation. Wayland. U.S.A.). Pretreatment evaluation included a clinical desrviption of the site, color, duration and photographs were taken. The effects were examined by fether photo graphs and telephone follow-up. The response was expressed as the percentage area cleared of the tattoo. The clearance was graded as follows: clear, >95%; excellent, 76-95%; good, 51-75%; fair, 26-50%; poor < 25%. The occurence of adverse events were also examined. RESULTS: 1""he results are summarized as follows: 1. Treatment with fluences that ranged from 6.0-8.0J/cm2 was given on average 1.7 times and better results were achived than expected in 80% of all patients with tattoo. 2. The effectiveness of laser therapy correlated with the number of treatments. 3. After 1 laser session, tattoos of black and darkblue showed better results than light blue in terms of color. 4. After 1 laser session, the sites of tattoos on upper extremitise showed better results than those of the eyebmw, eyeline and face. 5. Differences in duration after 1 laser session were not seen. 6. Hyperpigmentation in 2 cases and bulla formation in 1 case occurred and all complications had ceased after a few months. CONCLUSION: The alexandrite laser is an effective treatment for cosmetic, general and traumatic tattoos with a low incidence of significant adverse effects and provides excellent cosmetic results.