HPV genotyping in cervical cancer in Northern Thailand: adapting the linear array HPV assay for use on paraffin-embedded tissue

ObjectiveThe objective of this study was to review our experience with abdominal radical trachelectomy in patients with early-stage cervical cancer.MethodsWe performed a retrospective review of all patients who underwent an abdominal radical trachelectomy at the Instituto de Cancerologia—Clinica las Americas in Medellin, Colombia, between April 2002 and January 2008. Data collected included age, stage, histopathologic subtype, tumor size, evidence of lymph-vascular space invasion, estimated blood loss, number of perioperative blood transfusions, number and disease status of lymph nodes removed, disease status of surgical specimen, length of hospital stay, intraoperative and postoperative complications, follow-up time, and fertility outcomes.ResultsFifteen patients underwent an abdominal radical trachelectomy during the study period. The median patient age was 30 years (range, 25–38). Three patients had stage IA2 and 12 had stage IB1 cervical cancer. Eleven patients had squamous cell carcinoma and 4 had adenocarcinoma. Thirteen patients were diagnosed by cervical conization and 2 by colposcopically directed biopsy. All patients had tumors smaller than 2 cm. The median estimated blood loss was 400 ml (range, 200–1000). The median surgical time was 265 min (range, 210–330). The median number of units of packed red blood cells transfused per patient was 2. The median number of lymph nodes removed was 26 (range, 11–48). The median length of hospitalization was 3 days (range, 2–7). The median follow-up time was 32 months (range, 5–32). There was 1 intraoperative complication and 6 postoperative complications in 4 patients. No patient has had a recurrence. Three patients were able to conceive spontaneously; 1 delivered at 31 weeks' gestation, and 2 delivered at term.ConclusionAbdominal radical trachelectomy is feasible and can be performed safely in a developing country in well-selected patients with early cervical cancer who wish to preserve their fertility.     

Investigating online harassment and offline violence among young people in Thailand: methodological approaches,lessons learned

Violence in the physical (offline) world is a well-documented health and social issue among young people worldwide. In Southeast Asia, online harassment (defined as intentional behaviours to harm others through the Internet or through mobile devices) is less well documented. In this paper, we describe and critically discuss the mixed-methods data collection approach we used to build a contextualised understanding of offline violence and online harassment among 15- to 24-year-old students and out-of-school youth in Central Thailand. We mapped linkages between offline violence and online harassment, and with their possible correlates including gender, sexuality, and mobile media or Internet use. Data collection methods included in-depth interviews, focus group discussions and a custom-built, self-administered computerised survey. Using mixed methods enabled us to collect holistic qualitative/quantitative data from both students and out-of-school youth. In our discussion, we focus on gender, sexuality, class and ethnicity issues in recruiting out-of-school youth; definition and measurement issues; technical issues in using a computerised survey; ethical issues surrounding data collection from minors as well as privacy and confidentiality concerns in collecting data in both in-school and out-of-school settings; and the general implications of using mixed methods.     

Effects of initiation day of clomiphene citrate on the endometrium of women with regular menstrual cycles

OBJECTIVE: To investigate the effects of initiation time of clomiphene citrate (CC) on the endometrium of women with regular menstrual cycles. DESIGN: Randomized, double-blind, cross-over study. SETTING: Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. PATIENT(S): Thirty-three healthy female volunteers with regular menstrual cycles. INTERVENTION(S): The volunteers were randomized to receive either 100 mg of CC on days 1-5 and placebo on days 5-9 (study group) or placebo on days 1-5 and CC on days 5-9 (control group). After a wash-out period of 1 month of CC treatment, the medication was switched in each group. Ultrasonography was performed daily after day 10 of the cycle to detect ovulation. Ultrasonography for endometrial appearance and thickness, endometrial sampling, and blood samples obtained for determination of E(2) and P levels were performed 7 days after ovulation in both groups. MAIN OUTCOME MEASURE(S): Morphometric analysis, histologic dating, and ultrasonographic appearance and thickness of the endometrium. RESULT(S): Morphometric parameters, histologic dating, and ultrasonographic appearance and thickness of the endometrium were similar in both groups. CONCLUSION(S): Starting CC on either day 1 or day 5 of the menstrual cycle did not have any differential effects on the endometrium of women with regular menstrual cycles, particularly regarding the morphometric analysis, histologic dating, or ultrasonographic appearance.     

A pharmacokinetic study of paracetamol in Thai β-thalassemia/HbE patients

Background

Thalassemia may alter the pharmacokinetics of several drugs in thalassemic patients. Paracetamol is a commonly used analgesic and antipyretic drug which is extensively metabolized in the liver via glucuronidation. The aim of this study was to compare the pharmacokinetics of paracetamol (PCM) and its metabolites [paracetamol glucuronide (PCM-G), paracetamol sulfate (PCM-S), and paracetamol cysteine (PCM-C)] in 16 patients with 16 normal subjects.

Method

Following an overnight fast, a single dose of paracetamol (1,000 mg of Tylenol®) was given and blood samples were obtained at predose, 0.5, 1, 1.5, 2, 3, 4, 5, 7, and 9 h after dosing for determination of the plasma levels of PCM and its metabolites by high-performance liquid chromatography.

Results

There was no significant difference in maximum concentration of PCM between groups. However, a significantly shorter elimination half-life of PCM was observed in the thalassemic subjects (p<0.001). Total apparent clearance of PCM was significantly faster in thalassemic subjects (p<0.01) while the apparent volume of distribution of PCM did not change. The area under the concentration time curve (AUC_0->∞) of PCM-G and PCM-S increased in thalassemic subjects (p<0.05) whereas this parameter for PCM-C was slightly lower in the patients. The half-lives of PCM metabolites were significantly shorter (p<0.01) in thalassemic subjects.

Conclusion

The results indicate that the elimination of PCM and its metabolites in thalassemic subjects is faster than that in normal subjects. Our pharmacokinetic data provide additional evidence that plasma PCM-G is higher in thalassemic patients with hyperbilirubinemia, which could be a casual relationship in regulating the UDP-glucuronosyltransferase expression.     

Interaction of green tea catechins with renal organic cation transporter 2

1.?Green tea extract (GTE) and EGCG have previously shown to increase the uptake of MPP⁺ into Caco-2 cells. However, whether GTE and its derivatives interact with renal basolateral organic cation transporter 2 (Oct2) which plays a crucial role for cationic clearance remains unknown. Thus, this study assessed the potential of drug-green tea (GT) catechins and its derivatives interactions with rat Oct2 using renal cortical slices and S2 stably expressing rat Oct2 (S2rOct2).

2.?Both GTE and ECG inhibited MPP⁺ uptake in renal slices in a concentration-dependent manner (IC₅₀?=?2.71?±?0.360?mg/ml and 0.87?±?0.151?mM), and this inhibitory effect was reversible. Inhibition of [³H]MPP⁺ transport in S2rOct2 by either GTE or ECG (IC₅₀?=?1.90?±?0.087?mg/ml and 1.67?±?0.088?mM) was also observed.

3.?The weak and reversible interactions of GTE and ECG with rOct2 indicate that consumption of GT beverages could not interfere with cationic drugs secreted via renal OCT2 in humans. However, the rise of therapeutic use of GTE and ECG might have to take into account the significant possibility of adverse drug–green tea catechins interactions which could alter renal organic cation drug clearance.     

Chronic treatment with prebiotics,probiotics and synbiotics attenuated cardiac dysfunction by improving cardiac mitochondrial dysfunction in male obese insulin-resistant rats

European Journal of Nutrition - In metabolic syndrome, the composition of gut microbiota has been disrupted, and is associated with left ventricular (LV) dysfunction. Several types of prebiotics,...     

Curcumin I Mediates Neuroprotective Effect Through Attenuation of Quinoprotein Formation,p‐p38 MAPK Expression,and Caspase‐3 Activation in 6‐Hydroxydopamine Treated SH‐SY5Y Cells

6‐Hydroxydopamine (6‐OHDA) selectively enters dopaminergic neurons and undergoes auto‐oxidation resulting in the generation of reactive oxygen species and dopamine quinones, subsequently leading to apoptosis. This mechanism mimics the pathogenesis of Parkinson's disease and has been used to induce experimental Parkinsonism in both in vitro and in vivo systems. In this study, we investigated the effects of curcumin I (diferuloylmethane) purified from Curcuma longa on quinoprotein production, phosphorylation of p38 MAPK (p‐p38), and caspase‐3 activation in 6‐OHDA‐treated SH‐SY5Y dopaminergic cells. Pretreatment of SH‐SY5Y with curcumin I at concentrations of 1, 5, 10, and 20 μM, significantly decreased the formation of quinoprotein and reduced the levels of p‐p38 and cleaved caspase‐3 in a dose‐dependent manner. Moreover, the levels of the dopaminergic neuron marker, phospho‐tyrosine hydroxylase (p‐TH), were also dose‐dependently increased upon treatment with curcumin I. Our results clearly demonstrated that curcumin I protects neurons against oxidative damage, as shown by attenuation of p‐p38 expression, caspase‐3‐activation, and toxic quinoprotein formation, together with the restoration of p‐TH levels. This study provides evidence for the therapeutic potential of curcumin I in the chemoprevention of oxidative stress‐related neurodegeneration. Copyright © 2013 John Wiley & Sons, Ltd.     

Effect of flexibility exercise on lumbar angle: a study among non-specific low back pain patients

The study investigated the influence of lumbar flexibility exercise on the lumbar angle among patients with non-specific low back pain (LBP). Pre-experimental one-group pretest-posttest design trial was conducted at Health Service Center, Chulalongkorn University, Thailand. Thirty-five non-specific LBP patients with limitation in lower back range of motion and without neurological deficits were recruited (based on the LBP guidelines by RCGP 1999). Lumbar flexibility exercise program developed based on McKenzie therapy was performed individually each day for 2 weeks. Patients attended an exercise program daily in the first week under the supervision of a physiotherapist. The exercise program consisted of 7 sets a day (3-2-2 in the morning-afternoon-evening) in series of 10 repetitions for each set for 2 weeks. Lumbar angle was measured at the beginning and at the end of 2 weeks in order to determine the range of motion improved. The results indicated that the low back pain symptom improved as well as the angle.