Nurse-led Cardiovascular Diseases Risk Assessment and Communication using WHO/ISH Risk Prediction Chart in a Tertiary care Hospital of North India

Cardiovascular diseases (CVDs) contribute to most of the potentially preventable burden through early risk assessment. Nurse-led CVD risk assessment is an effective strategy to address the human resource crisis for CVD prevention. An interventional study was conducted in medicine wards of a tertiary care hospital in North India to train nurses in CVD risk assessment and its communication. All bedside nurses (n = 30) of selected wards were enrolled and trained in CVD risk assessment and communication using WHO/ISH risk prediction charts. Once fully trained, each nurse enrolled patients (>40 years of age) from their respective wards to assess and communicate CVD risk. To calculate the reliability of risk assessment, investigator simultaneously assessed CVD risk with nurses. The mean age of nurses was 32.07 ± 6.31 years. The results revealed that training significantly increased the knowledge of nursing personnel (P < 0.001). There was perfect inter?rater reliability agreement (Cohen’s k = 0.929) between nurses and investigators while assessing CVD risk. Nurses demonstrated good communication skills. The study concluded that nurses can be trained successfully in CVD risk assessment and communication. The study recommends the task shifting of CVD risk assessment to nurses after providing proper training

Adherence To Essential Hypertension Treatment Guidelines In A Tertiary Hospital In Nigeria

Objective: This study determined the level of prescribers’ adherence to the World Health Organization/International Society of Hypertension (WHO/ISH) guidelines for the management of hypertension at the Lagos University Teaching Hospital (LUTH), Nigeria. Methods: This study employed a retrospective cross-sectional design. Two groups were used: Group A (300 patients) were treated before the guidelines review in 2003, while Group B (200 patients) were treated after. The two study groups were compared, and systolic blood pressure of 130 mm Hg or above was taken as the index of hypertension. Results: There were 198 (66%) male patients in Group A, while Group B had 136 (68%) males. The highest age for Group A was 50–59 y for 89 (30%) patients, unlike group B that had 58 (29%) patients in aged 40–49 y as the highest. The highest blood pressure range for patients in Group A was 150–159 mm Hg for 64 (21%) patients, unlike Group B that had 43 (22%) patients as the highest in the same range. Furosemide was present in 282 (24%) prescriptions for group A patients. However, atenolol was present in 61 (20%) prescriptions for the same group. In group B, Furosemide was prescribed in 197 (97%) encounters, while Nifedipine was found in 81(40%) prescriptions. Conclusion: Prescribers at LUTH complied substantially with WHO/ISH guidelines in the management of hypertension. Diuretics and beta-blockers were used before the guideline review. After the review, diuretics and calcium channel blockers were the most frequently prescribed antihypertensives.

Assessment of the Cardiovascular Risk of Persons with Hypertension and Diabetes Attending Clinics and Hypertension/Health Club Meetings in the AMIGA Municipalities of Cavite, Philippines using WHO/ISH Risk Prediction Charts

Objectives@#This study aims to (1) determine the cardiovascular risk of persons with hypertension and diabetes attending hypertension/diabetic clinics or hypertension/health club meetings in the AMIGA (Alfonso, Mendez, Indang, General Emilio Aguinaldo and Amadeo) municipalities of Cavite; (2) suggest measures to improve the cardiovascular disease (CVD) program in these municipalities using the results of the study. @*Methods@#A cross-sectional study was performed on patients diagnosed with hypertension and/or diabetes who are attending clinics or club meetings in the barangays of the five AMIGA municipalities of Cavite. Participants were interviewed using an abbreviated version of the World Health Organization (WHO) STEPS questionnaire on risk factors. The participants’ anthropometric measurements were obtained and their total blood cholesterol levels determined. CVD risk was then estimated using the WHO / International Society of Hypertension (ISH) risk prediction chart for the Western Pacific Region B. @*Results@#1,032 participants from 27 barangays qualified for the study. Participants were predominantly female (74%); over-all mean age was 58.43 years. The majority of the participants (79.17%) were found to be in the low-risk group; 11.34% were in the moderate risk group; 4.46% were in the high-risk group; while 5.05% were in the very high-risk group. Majority of the participants were also found to be obese. Mean total cholesterol was 207.02 mg/dl. @*Conclusion@#Majority of participants were stratified in the low-risk category (<10% chance to have cardiovascularevents in the next 10 years), while 9.5% were in the high-risk category (≥20% risk). Obesity is a major risk factor that could be addressed in this population.

Factors Associated with 10 year Risk of Myocardial Infarction and Stroke in Rural Areas of Varanasi, India

Introduction: Cardiovascular diseases (CVD) are a group ofdiseases that involves mainly Coronary Artery Disease (CAD)also known as Myocardial Infarction (MI) and Stroke. Thismay be caused by both Physiological and behavioural riskfactors. High blood pressure, hyperglycaemia, dyslepidemiaand obesity are physiological risk factors, while smoking, lackof exercise, unhealthy dietary practices and excessive alcoholconsumption are behavioural risk factors. Study objective wasto find out the risk factors associated with occurrence of 10year total risk of cardiovascular events (MI and Stroke) inrural areas of Varanasi District.Material and methods: This was a community based crosssectional study conducted in Varanasi district of Uttar Pradesh.All population aged 40 years and above of both genderswere included in this study. Interview schedule was used tocollect the baseline data and an anthropometric measurementand World Health Organization/ International Society ofHypertension (WHO/ISH) risk prediction chart for Indianpeople was used for risk assessment of MI and Stroke.Results: The prevalence of various risk factors amongparticipants was as obesity, 32.5% (95% CI: 30.4%-34.7%);hypertension, 29.0% (95% CI: 27.0%-31.1%); diabetes 6.1%(95% CI: 5.1%-7.3%) and smoking, 18.3% (95% CI: 16.6%-20.1%). The overall prevalence of 10 year risk of MI andStroke was found 26%. Out of these 16% (95% CI: 14.0%-17.3%) and 6% (95% CI: 4.9%-7.1%) respondents were inmoderate and high risk respectively. While 4% (95% CI:3.5%-5.3%) respondents had very high risk of MI and Stroke.Age and sex were found significantly associated with the riskof MI and Stroke. Risk factors like hypertension (P<0.05,χ2=516.39), diabetes (P<0.05, χ2=53.74) and smoking(P<0.05, χ2=41.06), were also significantly associated withthe development of MI and Stroke.Conclusion: This study shows the positive significantassociation between several risk factors (i.e. age, gender,hypertension, diabetes and smoking) with 10 year risk fordeveloping MI and Stroke.

Prevalence of risk factors and 10 year risk estimation of cardiovascular diseases among rural population of Mysuru, Karnataka

Background: Cardiovascular diseases (CVD) are leading cause of death among non-communicable diseases (NCD). Many people in developing countries are detected late and die from NCDs, often in their most productive years. Prevention of CVD is an essential step to control the epidemic of NCDs. Thus, this study was undertaken to assess the prevalence of risk factors and to estimate the risk of CVD in the next 10 years.Methods: A community based cross-sectional study was conducted among 608 individuals aged ≥40 years in rural area of Mysuru. Data was collected using Semi structured questionnaire and 10 year CVD risk was estimated using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts.Results: A total of 608 study participants (mean age 56.76±11.07 years; Male:Female ratio 1.2:1) were included in the study. The prevalence of tobacco (32.9%) and alcohol (20.1%) consumption was significantly higher among males compared with females. Hypertension, diabetes and obesity prevalence was 39.5%, 15.5% and 28.1% respectively. One-fifth of population had moderate (20-39%) estimated risk and 7.4% had very high (≥40%) risk of developing CVD event in next 10 years. The estimated high risk (≥30%) of CVD events was statistically higher among individuals who were non-literates, unemployed, physically inactive, middle and above socioeconomic status.Conclusions: In the present study, CVD risk factors and estimated risk of CVD were significantly prevalent in the rural population. The use of simple tools like WHO/ISH risk prediction charts to estimate CVD risk is recommended in low resource settings at Community level, as the benefit of screening outweighs the risk of missing an opportunity to prevent CVD.

Factores clinicopatológicos asociados a la amplificación del genHER2/neu en pacientes con cáncer de mama HER2 2+ / Clinicopathological factors associated with the amplification of the HER2 /neu genein patients with breast cancer HER2 2+

Introducción. Un subgrupo de los carcinomas de mama sobreexpresa el receptor 2 del factor de crecimiento epidérmico (HER2). La determinación de esta sobreexpresión se realiza por inmunohistoquímica. La dificultad de diagnóstico surge cuando el resultado es ambiguo (2+), haciendo necesario realizar hibridación in situ (ISH) para determinar la amplificación del gen HER2/neu. Objetivo. Determinar si la amplificación del gen HER2/neu en los casos HER2 2+, se encuentra asociado a factores clinicopatologicos pronósticos. Diseño. Estudio descriptivo de corte transversal. Institución. Servicio de patología quirúrgica, Hospital Guillermo Almenara Irigoyen. Lima, Perú. Participantes. Casos de cáncer de mama HER2 2+. Metodología. Se estudiaron 117 casos de cáncer de mama HER2 2+ diagnosticados entre los años 2010 2015, a los que posteriormente se les realizó ISH. Todos los datos fueron analizados con el programa estadístico SPSS 22. Se utilizó el test de Chi cuadrado para analizar la asociación entre las variables. Principales medidas de resultados. Factores asociados a la amplificación del gen HER2/neu. Resultados. La amplificación del gen HER2/neu se observó en 41% del total de casos. En estos, se observó con mayor frecuencia un grado histológico III (66%), compromiso ganglionar presente (61%), tamaño tumoral ≥ 2 cm (86%) y Ki 67 ≥ 20% (83%). Se encontró una asociación estadísticamente significativa con una edad ≥ 50 años (X2 test, P=0,004) y el grado histológico III (X2 test, P=0.017). Conclusión. La amplificación del gen HER2/neu en casos ambiguos está asociado a una edad ≥ 50 años y grado histológico III.

Introduction: A subgroup of breast carcinomas overexpress epidermal growth factor-2 (HER2). The determination of this overexpression is carried out by immunohistochemistry. The difficulty of diagnosis by this method arises when the result is ambiguous (2+), thus it is necessary to perform in situ hybridization (ISH) to determine the amplification of the HER2/neu gene. Objective: To determine if, in HER2 2+ cases, the amplification of the HER 2 / neu gene is associated with prognostic clinicopathological factors. Design: Observational, cross-sectional, descriptive study. Institution: Surgical pathology service, Guillermo Almenara Irigoyen Hospital. Lima, Peru. Participants: Cases of breast cancer HER2 2+. Methodology: We studied 117 cases of Her2 2+ breast cancer diagnosed between the years 2010 2015, to which ISH was subsequently performed. All the data were analyzed with the statistical program SPSS 22. The Chi-square test was used to analyze the association between the variables. Main results measures: Factors associated with the amplification of the HER2 / neu gene. Results: Amplification of the HER2 / neu gene was observed in 41% of the total cases. In these, a histological grade III (66%), lymph node involvement (61%), tumor size ≥ 2 cm (86%) and Ki 67 ≥ 20% (83%) were observed more frequently. A statistically significant association was found with an age ≥ 50 years (X2 test, P = 0,004) and histological grade III (X2 test, P = 0.017). Conclusion: Amplification of the HER2/ neu gene in ambiguous cases is associated with an age ≥50 years and histological grade III

Human papillomavirus (HPV) in Egyptian females: study by cytology, histopathology, colposcopy and molecular diagnosis of high risk types

Objectives: In Northern Africa, the region Egypt belongs to, about 10.7% of women are estimated to harbour cervical human papillomavirus (HPV) infection and 78.4% of invasive cancers are attributed to HPVs 16 or 18. We aimed at comparing HPV detection by ISH-PCR tissue with other conventional available cheaper techniques, finding which of them can be relied upon in a developing country like Egypt for HPV detection. Methods: Sixty patients were included. For them colposcopy, PAP smear, histopathology and detection of HPV using ISH PCR tissue and PCR swab were achieved. Results: PCR-ISH tissue was positive in 53.33%, 46.6% were negative. Pap smear was negative in 26 cases (43.33%) and 43 cases (56.67%) were positive. LSIL with perinuclear halo represented nearly half of the positive cases (16/34; 47.05%), 10 cases were diagnosed as HSIL, 4 cases as ASCUS and 4 as AGC. Histopathology was negative in 12 (20%) cases and 48 (80%) cases were positive. CIN I and CIN I+ koliocytosis represented half of the cases (30/60) and more than half of positive cases (30/48; 62.5%). Comparing the results of pap smear, histopathology, colposcopy and PCR swab with ISH PCR tissue, highly significant results were seen with sensitivity of 87.5%, 100%, 62.5% and 56.2% respectively but the specificity were 78.6%, 42.9%, 28.6% and 100% respectively. Conclusion: Conventional cytology and histopathology were sensitive tests for detection of HPV. This may help for early detection of cancer cervix in a developing country like Egypt. PCR swab showed the highest specificity and the lowest sensitivity.

Epstein-Barr virus-associated gastric carcinoma in Brazil: comparison between in situ hybridization and polymerase chain reaction detection

Epstein-Barr virus (EBV) has been associated with 10% of gastric carcinomas. The aim of this study was to determine the frequency of EBV in gastric carcinomas in Brazil assessed by in situ hybridization (ISH) and PCR, which would contribute to the characterization of the clinical and pathological aspects of EBV-associated gastric carcinomas. One hundred and ninety-two gastric carcinoma cases were collected at hospitals in two Brazilian states. Seventy-three out of 151 cases were PCR(+), while 11/160 cases were ISH(+). Nine out of eleven ISH(+) cases displayed a diffuse staining pattern and 2 out of 11 a focal pattern. Both techniques showed that the EBV(+) cases were characterized by their association with males, older patients, lower gastric region, intestinal type, advanced stage and poorly to moderately differentiated tumors. The concordance between the two techniques was 55.8% (Cohen's kappa index = 0.034). Four cases were ISH(+)/PCR(-), while 49 cases were PCR(+)/ISH(-). Only two cases showed stained lymphocytes by ISH and one of them was PCR(-). The observed discrepancy between the two techniques could not be explained just by the elevated accuracy of PCR. ISH(+)/PCR(-) carcinomas may be encountered if EBV is not present in the whole tumor tissue or if there are polymorphisms in the sequences of the viral genome amplified. On the other hand, the high frequency of PCR(+) results associated with the absence of ISH staining in lymphocytes and/or tumors cells suggests that the virus may be present in tumor cells or other cell types without expressing EBER1, the target of the ISH technique.

Dendritic eIF4E-binding Protein 1 (eIF4E-BP1) mRNA Is Upregulated by Neuronal Activation

Long-term synaptic plasticity requires addition of new proteins at the synaptic site. The local protein synthesis at subsynaptic sites confers advantageous mechanisms that would regulate the protein composition in local domains on a moment-by-moment basis. However, our information on the identities of 'dendritic' mRNAs is very limited. In this study we investigated the expression of the protein and mRNA for eukaryotic translation initiation factor 4E (eIF4E)-binding protein 1 (4EBP1) in cultured rat hippocampal neurons. Immunocytochemistry (ICC) showed that 4EBP1 protein is highly localized to the nucleus. In dendrites most 4EBP1 punctae were not colocalized with those of eIF4E. In situ hybridization (ISH) and Fluorescence ISH (FISH) revealed that 4EBP1 mRNA was present in dendrites. The FISH signals formed clusters along dendrites that colocalized with ICC signals for Staufen, a marker for RNA granules. The neuronal activation by KCl (60 mM, 10 min) significantly increased the density of 4EBP1 FISH signals in the nucleus after 2 hr, and both in the nucleus and dendrites after 6 hr. Our results indicate that 4EBP1 and its mRNA are present in dendrites, and the mRNA is upregulated and transported to dendritic domains in RNA granules upon neuronal activation.

HPV in situ hybridization and immunohistochemical expression of L1 capsid protein in cervical intraepithelial neoplasia / 대한산부인과학회지

OBJECTIVE: HPV in situ hybridization (ISH) is able to detect HPV DNA and identify integrated HPV DNA by punctuate staining and episomal HPV by diffuse staining in the nuclei. Because the expression of L1 capsid protein disappears after integration of HPV DNA, immunohistochemistry (IHC) of L1 capsid protein can be used as a indirect evidence of integration. Therefore, we tried to evaluate the usefulness of HPV ISH and IHC of L1 capsid protein in Cervical intraepithelial neoplasia (CIN). METHODS: Twenty six cervical lesions from patients with CIN and 19 normal cervical epithelium from patients with leiomyoma were evaluated with HPV ISH and IHC of L1 capsid protein. RESULTS: HPV ISH was positive in 80.8% (21/26) in CIN. Among 21 positive cases, diffuse staining was observed in 42.9% and punctuated and diffuse staining in 57.1%. L1 capsid protein was positive in 65.4% (17/26) of cervical tissue sections and 15.4% (4/26) of cervical smears. The punctuated staining of HPV ISH was correlated with high grade CIN (P=0.007) but expression of L1 capsid protein was not associated with grade of CIN (P>0.05). CONCLUSION: HPV ISH is a useful tool to identify integrated HPV DNA in paraffin-embedded, formalin-fixed cervical tissue. HPV integration confirmed by HPV ISH was associated with high-grade CIN. IHC of L1 capsid protein showed better result using cytology smears than tissue sections.

Expression and significance of high mobility group A2 in uterine leiomyomas and neighbour normal myometrium / 第三军医大学学报

Objective To study the role of HMGA2 in the occurrence and the progression of uterine leiomyomas.Methods Fifty cases of uterine leiomyomas who met the inclusion criteria(aged 30-50 years old,free from hormone at least for 6 months before surgery,no other diseases,postoperative pathological diagnosis as uterine leiomyoma) admitted to our hospital from January to July 2003 were studied.The expression of HMGA2 mRNA in uterine leiomyomas and neighbour normal myometrium was detected by ISH.Results HMGA2 mRNA was strongly expressed in 30 cases of uterine leiomyomas but not expressed in neighbour normal myometrium.There was no difference in HMGA2 mRNA between proliferative stage and progestational stage.Conclusion The increased expression of HMGA2 in uterine leiomyomas may be important in the occurrence and the progression of uterine leiomyomas.

Detection of Epstein-Barr Virus(EBV) and expression of EBV lytic genes in EBV-positive gastric carcinomas / 中国癌症杂志

Purpose:To explore the relationship between Epstein-Barr virus(EBV) infection and gastric carcinoma and the role of EBV lytic genes in the tumorigenesis of EBV-gastric carcinomas. Methods:185 gastric carcinoma tissues and 185 corresponding para-carcinoma tissues were tested for EBV genome by polymerase chain reaction (PCR)-southern analysis. EBV-encoded small RNA 1(EBER1) of the PCR positive specimens was detected by in situ hybridization (ISH). Gastric carcinoma with positive EBER1 signals was confirmed as EBV-positive gastric carcinoma. RT-PCR and Southern blotting were used to detect the expression of EBV lytic genes (immediately early genes BZLF1 and BRLF1, early genes BARF1 and BHRF1, late genes BcLF1 and BLLF1) in EBV-positive gastric carcinomas. Results:There were 13 EBV positive samples in gastric carcinomas (7.03%). No EBV positive sample was found from corresponding para-carcinomas. The difference of the EBV positivity was significant between carcinoma and corresponding adjacent carcinoma tissues(? 2= 11.0769,P=0.0009). In our series, age, pathological differentiation, clinical stages, lymph node metastasis and location of cancer were not different between EBV-positive and EBV-negative gastric carcinomas in (P=0.973, 0.141, 0.259, 0.586, 0.062, respectively), while sex was significantly different between EBV-positive and EBV-negative gastric carcinomas(? 2=5.2317,P=0.021). The EBV positivity of male was higher than that of female. Of the 13 EBV-associated samples, 7 exhibited BcLF1 transcript and 2 exhibited BHRF1 transcript. The transcripts of BZLF1 were detected in 6 cases, and those of BARF1 also in 6 cases. No BLLF1 and BRLF mRNA were detected in the 13 EBV-positive samples. Conclusions:EBV infection is associated with the development of gastric carcinoma. Lytic EBV infection occurs in part of the EBV-associated gastric carcinomas, and early genes BARF1 and BHRF1 may play an important role in the tumorigenesis of the EBV-positive gastric carcinoma.

A study on expression of KGF mRNA in human NSCLC and its role in the development of lung cancer / 中国癌症杂志

Purpose:To investigate expression of keratinocyte growth factor(KGF) messenger ribonuclunc acid in human NSCLC and to study the role of KGF in the development of NSCLC. Methods:The expression of KGF mRNA in 50 cases with NSCLC was detected by in situ hybridization (ISH). Results:On ISH slides, positive KGF mRNA was mainly shown as fusiform stain in plasma of fibroblast and blood vessel smooth muscle cell in mesenchymal of NSCLC, also, some parenchyma cell plasma was stained. The positive rate of KGF mRNA in tumor(86%) is statistically higher than that in normal tissue(24%)(P

Estudo do processo de refino do óleo de pescado / Study of fish oil refining process

No presente trabalho realizou-se um estudo do processo de refino de óleo de pescado, determinando-se através de um Planejamento Experimental Fatorial as variáveis que influenciam significativamente as etapas de neutralizaçäo e branqueamento. O óleo bruto de pescado foi tratado com ácido fosfórico 85(por cento), neutralizado com hidróxido de sódio 20(por cento)p/p em excesso, lavado com água quente e seco sob o vácuo, sendo branqueado com substâncias adsorventes, e filtrado. Na etapa de neutralizaçäo obteve-se um óleo com Índice de Perióxidos de 2,1 mEq/Kg e 0,04(por cento) de Ácidos Graxos Livres, na faixa de 40oC e 40(por cento) de excesso de NaOH 20(por cento), sendo a temperatura e o excesso de NaOH, as variáveis de principal influência no processo. No estudo da etapa de branqueamento foi utilizado um planejamento experimental fatorial completo (2k), tendo como parâmetros a temperatura, o tempo de retençäo, a (por cento) Adsorvente e a (por cento) Carväo/Adsorvente, sendo que estes últimos influenciaram significativamente na cor lovibond e no Índice de Perióxidos de óleo clarificado. Os Melhores resultados para a cor Lovibond (30 Amarelo e 1,24 Vermelho) e para o Índice de Perióxido (3,93 mEq/Kg) do óleo clarificado foram encontrados nas faixas de 70oC e tempo de 20 minutos, com 5,0(por cento) de Adsorvente e 10(por cento) de (Carväo/Adsorvente). (AU)

In the current work a process of refining fish oil was studied that determined, through Factorial Experimental Design, the variables which significantly influence the neutralization and bleaching stages. The crude fish oil was treated with phosphoric acid 85%, neutralized with sodium hidroxide 20% w/w in excess, washed with hot water and dried under vacuum, being bleached with adsorbent substances and filtered. During the neutralization stage some oil with Peroxide Values of 2.1 mEq/Kg and 0.04 of Free Fatty Acids was obtained, in the range of 40∞C and 4.0% excess NaOH 20%. The temperature and the excesso NaOH were the main influential variables of the process. During the bleaching stage, a complete factorial experimental design (2 K) involving temperature, retention time, %Adsorbent and %Charcoal/Adsorbent was used. The % Adsorbent and% Charcoal/Adsorbent significantly influenced the Lovibond color and Peroxide Values of the bleached oil. The best results for the Lovibond Red 1.24, Lovibond Yellow 30 and Peroxide Value of 3.93 meq/Kg of the bleached oil were found in the range of 70∞C and time of 20 minutes, with 5.0% of adsorbent and 10.0% of Charcoal/Adsorbent. (AU)

Clinical significance of kaposi's sarcoma-associated herpesvirus(KSHV) infection in patients of multiple myeloma / 대한내과학회지

BACKGROUND: Kaposi's sarcoma-associated herpesvirus (KSHV) been shown to be associated with human diseases including Kaposi's sarcoma, pleural effusion lymphoma, multicentric Castleman's disease. The IL-6 may both stimulate myeloma growth and prevent apoptosis of malignant plasma cells. Interestingly, viral IL-6(vIL-6), homolog to human interleukin-6(IL-6) in KSHV genome retains biologic activity. Thus, oncogenic role of the KSHV has been proposed as a pathogenesis of the multiple myeloma. We used ISH to determine the frequency of patients with multiple myeloma and plasmacytosis associated with KSHV-infected BM cells in fresh core biopsies and to determine the correlation between KSHV infection and clinical characteristics. METHODS: Bone marrow(BM) biopsy samples from 16 cases of multiple myeloma, 2 cases of monoclonal gammopathy of undetermined significance(MGUS) were obtained from the pathology division of Soon Chun Hyang University Hospital, Seoul, Korea. Biopsy sample of Kaposi's sarcoma for positive control and BM biopsy samples of myelodysplastic syndrome(MDS) and malignant lymphoma for negative control were obtained. Bitinylated probe to KSHV were prepared with the following sequences: 5' to 3' TGCAGCAGCTGTTGGTGTACCACATATCT. and in situ hybridization (ISH) was performed. RESULTS: Among the 18 patients. Two patients were MGUS and among 16 patients with multiple myeloma, 1 in stage IB disease, 1 stage IIB disease, 8 stage IIIA disease, 4 stage IIIB diseases and 2 in variant of multiple myeloma, extramedullary plasmacytoma. Strong positive signal was detected in nuclei and cytoplasm of the malignant cells of biopsy sample from 1 cases of Kaposi's sarcoma by ISH(positive control). Signal was not detected in BM biopsy samples of 7 cases from MDS and malignant lymphoma(negative control). Among 16 patients with multiple myeloma, 15 demonstrated viral positive cells and 2 cases with MGUS also showed viral positive cells by ISH. Signal was detected in nuclei and cytoplasm of stromal cells. Signal was strongly detected in MGUS than multiple myeloma. Positivity of the KSHV was not related with stage of the patients with multiple myeloma. One patients with multiple myeloma was studied at diagnosis and after chemotherapy. After chemotherapy KSHV was not detected. CONCLUSION: In MGUS and multiple myeloma, KSHV infects the stromal cells of BM rather than malignant plasma cells. On the basis of these data, we have supposed KSHV to play a role in transformation from MGUS to multiple myeloma. Particularly, due to the fact that signal of ISH was strongly detected in MGUS and was not detected in one case with multiple myeloma, it was presumed that KSHV was not major role in already advanced multiple myeloma but statistic significance was not demonstrated because of small numbers of cases. Further studies to reveal the correlation of KSHV and pathogenesis of multiple myeloma are needed.

Expression of the p53 Protein and Detection of HPV by ISH in Sinonasal Inverted Papilloma / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: The p53 protein is a 53 kD phosphoprotein. It is also one of the early recognition markers of malignancy and can be used to predict the aggressive behaviors of tumor. The human papilloma virus (HPV) is a species-specific, epitheliotrophic, double-stranded DNA virus. The purpose of this study was to evaluate the expression rate of p53, and to investigate whether a correlation exists between the rate of recurrence and the severity of lesion. We also investigated whether p53 expression rate and HPV affect recurrence and carcinogenesis of inverted papilloma. MATERIALS AND METHODS: Twenty-two cases of the inverted papilloma and 6 cases of squamous cell carcinoma arising in the inverted papilloma were used for the study. We used immunohistochemical staining for p53 and performed the molecular study of HPV DNA with in situ hybridization (ISH) on the paraffin embedded materials. RESULTS: 1) The overall expression rate of p53 was 39% (11/28). A significant correlation was observed between p53 protein accumulation and the severity of the lesion (p=0.0015). 2) Seven of 11 patients who tested positive for p53 showed recurrence, whereas two of the 12 patients who tested negative for p53 showed recurrence. There was a correlation between the rates of p53 expression and recurrence (p=0.029). 3) The HPV was detected in four cases (13%) of inverted papilloma. There was no statistical significance between HPV and the rate of recurrence(p=0.147). CONCLUSION: The results demonstate that p53 mutations and HPV may play a role in the oncogenesis of inverted papilloma.

Clinical Analysis of Interhemispheric Subdural Hemorrhage and Tentorial Hemorrhage

A propecive analysis of 50 patients with acute interhemisphric subdural hemorrhage and tentorial hemorrhage, an unusual pattern of acute subdural hematoma, who were managed in a uniform way was analyzed to related outcome to hemorrhagic site, initial Glasgow Coma Scale(GCS) and combined injuries. The incidence of acute interhemisphric subdural hemorrhage(ISH) and tentoria hemorrhage(TH) after head trauma was 3.83%, 50 cases among 1303 head injured cases. And 80% of the above hemorrhage disapperaed within two weeks after trauma. There was no significant relationship between feature of hemorrhage and intial GCS(P>0.05), but there was highly significant relationship between initial GCS and Glasgow Outcome Scale(GOS) (p<0.001). There noted significant relationship between initial combined injury and GOS(p<0.01), and also brainstem injury and GOS(p<0.001).