Proper hand scrubbing is very important for the prevention of food poisoning. The scrubbing checker is a method for determining the level of cleanliness based on light emitted from the hands after washing with a lotion containing fluorescence. In March 2008, we examined the hands of 33 individuals on the staff of the Department of Dietetics, Konan Kosei Hospital, using the ATP wipe test and the scrubbing checker. We also investigated the effectiveness of sanitary education using both methods. The ATP wipe test was conducted twice. The first test was done after normal scrubbing, and scrubbing education was given later. In order to evaluate the effectiveness of sanitary education, the second test was done approximately one week after the first test and the ATP levels obtained before and after sanitary education were compared. The measurements were evaluated in three stages:grade A (satisfactory), B (borderline) and C (unsatisfactory). For sanitary education, hand cleanliness was confirmed by each of the participants themselves using the scrubbing checker. In the first test, 58% of those tested were evaluated as grade A. Sanitary education using the scrubbing checker showed that scrubbing of the nails was inadequate in 64% of the examinees. Therefore, education was given about scrubbing the nails against the palm of the other hand. In the second test after scrubbing education, the percentage of those evaluated as gradeA increased to 91%. As a result of these findings, it was concluded that sanitary education using the ATP wipe test and the scrubbing checker is effective. We plan to prevent food poisoning by conducting both tests periodically hereafter.
educational ; Azathioprine ; Hand ; Grade ; Educational Background

OBJECTIVES: This study was carried out to determine the role of p53 and p21 in the pathogenesis of prostatic adenocarcinoma and their association with tumour grade. METHOD: Sixty-seven histologically confirmed prostatic adenocarcinoma cases collected from Hospital Universiti Kebangsaan Malaysia and General Hospital Kuala Lumpur were studied. The formalin-fixed paraffin-embedded tissues were stained with monoclonal antibody p53 (clone DO-7) and p21 (clone SX II8) using standard avidin-biotin complex immunohistochemistry (IHC) after microwave antigen retrieval. The adenocarcinomas were graded histologically according to Gleason score: low grade = score 2-4, intermediate grade = score 5-7, high grade = score 8-10. Histological grade was analysed against IHC expressions of p53 and p21 and against patient age and ethnicity. RESULTS: IHC positivity for p53 was expressed in 1/2 (50%) low grade, 14/33 (42%) intermediate grade, and 21/32 (66%) high grade tumours. p21 was expressed in 0/2 low grade, 16/33 (48%) intermediate grade and 15/32 (47%) high grade tumours. p53 and p21 expressions did not show statistically significant correlation with the different grades of prostatic adenocarcinoma or with each other (p = 0.42). There was no correlation between tumour grade and age or ethnicity. CONCLUSION: Although the p53 positivity rate was higher in high-grade prostate adenocarcinoma, this was not statistically significant. We found that a combined expression of p21 and p53 was not correlated with tumour grade. We could not confirm that p21 expression was dependent on p53 expression.
Grade ; oncoprotein p21 ; Adenocarcinoma of prostate ; overexpress ; ethnicity

Dendritic cells (DC) are professional antigen presenting cells of the immune system. Through the use of DC vaccines (DC after exposure to tumour antigens), cryopreserved in single-use aliquots, an attractive and novel immunotherapeutic strategy is available as an option for treatment. In this paper we describe an in vitro attempt to scale-up production of clinical-grade DC vaccines from leukemic cells. Blast cells of two relapsed AML patients were harvested for DC generation in serum-free culture medium containing clinical-grade cytokines GM-CSF, IL-4 and TNF-alpha. Cells from patient 1 were cultured in a bag and those from patient 2 were cultured in a flask. The numbers of seeding cells were 2.24 x 10(8) and 0.8 x 10(8), respectively. DC yields were 10 x 10(6) and 29.8 x 10(6) cells, giving a conversion rate of 4.7% and 37%, respectively. These DC vaccines were then cryopreserved in approximately one million cells per vial with 20% fresh frozen group AB plasma and 10% DMSO. At 12 months and 21 months post cryopreservation, these DC vaccines were thawed, and their sterility, viability, phenotype and functionality were studied. DC vaccines remained sterile up to 21 months of storage. Viability of the cryopreserved DC in the culture bag and flask was found to be 50% and 70% at 12 months post cryopreservation respectively; and 48% and 67% at 21 months post cryopreservation respectively. These DC vaccines exhibited mature DC surface phenotypic markers of CD83, CD86 and HLA-DR, and negative for haemopoietic markers. Mixed lymphocyte reaction (MLR) study showed functional DC vaccines. These experiments demonstrated that it is possible to produce clinical-grade DC vaccines in vitro from blast cells of leukemic patients, which could be cryopreserved up to 21 months for use if repeated vaccinations are required in the course of therapy.
Vaccines ; month ; Grade ; Clinical ; Lower case ecks

A 60-year-old female developed a right parotid swelling six months after surgery for intra-oral squamous cell carcinoma. Fine needle aspiration (FNA) cytological smears showed dissociated large and small pleomorphic tumour cells with abundant mitoses and oncocytic features. A cytological diagnosis of parotid acinic cell carcinoma (ACC) was made. Histological study of the subtotal parotidectomy specimen showed a papillary cystic variety of acinic cell carcinoma (ACC-PCV). FNA cytological features in this case of ACC-PCV differs from the two previously reported cases in that it showed prominent oncocytic and high grade features and absence of papillary pattern in the cytological smears. ACC-PCV is an uncommon tumour and knowledge of its varied FNA cytological features is important for the diagnosis of this neoplasm.
Fine needle biopsy, NOS ; Cells ; Carcinoma ; Grade ; Packed cell volume

Hepatocellular carcinoma (HCC) ranks as the fifth most common cancer with an increasing frequency worldwide. "Nuclear atypia", one of the critical features in histological diagnosis of malignancy and grading of the tumour, is generally ascertained through eyeballing. A study was conducted at the Department of Pathology, University of Malaya Medical Centre to assess whether nuclear area, (surrogate measure for nuclear size) and standard deviation (surrogate measure for nuclear pleomorphism) when objectively measured via computer-linked image analysis differs between (1) benign and malignant liver cells and (2) different grades of HCC. A 4-microm thick H&E stained section of 52 histologically re-confirmed HCC with 36 having benign, non-dysplastic surrounding liver were analysed using the Leica Q550 CW system. 10 consecutive non-overlapping, non-mitotic and non-apoptotic nuclei of HCC and surrounding benign hepatocytes respectively were manually traced at 400x magnification on the computer monitor and the nuclear area for the particular cell computed in arbitrary units by the Leica QWIN software. A total of 360 benign hepatocytic nuclei, 240 low grade HCC and 280 high grade HCC nuclei were traced. The mean nuclear area of the benign hepatocytes (37.3) was significantly smaller (p < 0.05) than that of both low grade (65.2) and high grade HCC (80.0). In addition, the mean nuclear area of high grade HCC was significantly larger (p < 0.05) than the low grade HCC. SD of the nuclear areas was lowest in benign hepatocytes (9.3), intermediate in low grade HCC (25.0) and highest in high grade HCC (25.6). These findings indicate that computer-linked nuclear measurement may be a useful adjunct in differentiating benign from malignant hepatocytes, in particular in small biopsies of well-differentiated tumours, and in predicting survival after surgical resection and transplant.
Grade ; Benign ; Computers ; Malignant Neoplasms ; Cancer cells grading system

A retrospective analysis of 15 cases intracanalicular acoustic neuroma that undergone tumour excision by translabyrinthine approach spanning from August 1996 until December 2002 is presented. The main presenting complaints are unilateral hearing loss (100%) and tinnitus (86.7%). The mean age of presentation was 48.5 years old. Magnetic resonance imaging is the most important investigation tool to diagnose acoustic neuroma. At six months post operatively, the facial nerve was normal or near normal (grade I and II) in 46.6%, grade III to IV in 46.6% and grade V to VI in 6.7% of the cases respectively. There were also four cases of post operative cerebrospinal fluid leak, which was successfully managed with conservative measures. The translabyrinthine approach is the most familiar surgical technique employed by otologist. It is the most direct route to the cerebellopontine angle and internal auditory canal. It requires minimum cerebellar retraction. However, it sacrifices any residual hearing in the operated ear.
Neuroma, Acoustic ; Grade ; seconds ; Complications Specific to Antepartum or Postpartum ; sacrifice

Mantle cell lymphoma is an uncommon non-Hodgkin's lymphoma. In a period of four years, 13 cases of mantle cell lymphoma were diagnosed in our department, comprising 3.1% of all non-Hodgkin's lymphoma diagnosed. The mean age of presentation was 52 years with a slight male preponderance. The disease was nodal in twelve and extra-nodal in tonsil in one. Five patients had bone marrow involvement. Five cases showed a nodular pattern on lymph node biopsy while the remaining eight had a diffuse pattern. Immunophenotyping showed positivity for CD20 and cyclin D1. Despite certain morphological similarity to other low-grade lymphomas, mantle cell lymphoma has a characteristic appearance of its own. It is more aggressive than other low-grade lymphomas and hence needs to be accurately diagnosed.
Malignant lymphoma, lymphocytic, intermediate differentiation, diffuse ; Pattern ; Five ; Lymphoma, Low-Grade ; Lymphoma, Non-Hodgkin's

Low grade lymphomas are malignancies of predominantly small lymphocytes that typically have long median survival periods due to low proliferative rates. It is considered an indolent disease, but patients with low grade lymphoma can almost never be cured with conventional treatment. New low-grade lymphoma entities have been classified by the International Lymphoma Study Group (ILSG) and are also categorized into the Revised European American Lymphoma (REAL) classification. The REAL classification utilizes a multiparameter definition of clinico-pathologic and biologic entities. According to this classification, we investigated the incidence, various clinical characteristics, treatment outcome and prognostic factors of low grade lymphoma. Many clinical characteristics of low grade lymphoma in Korea differed from those of Western countries, especially in the incidence, therapeutic outcome and prognostic factors. In Korea, although the general incidence of low grade lymphoma is relatively low, the relative number of mucosa-associated lymphoid tissue lymphoma (MALToma) is very high, and the overall survival rate is better than that reported of Western countries. Thus, further investigation on treatment outcome and prognosis of low grade lymphoma entities, other than mucosa-associated lymphoid tissue lymphoma, are warranted.
Adolescent ; Adult ; Aged ; Female ; Human ; Immunophenotyping ; Lymphoma, Low-Grade/mortality/pathology/*therapy ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Treatment Outcome

In order to evaluate the role of radiation therapy in the management of low-grade mucosa-associated lymphoid tissue lymphoma of the stomach (MLS), in patients with no evidence of Helicobacter pylori (H. pylori) or who had not responded to H. pylori eradication treatment, we analyzed the treatment outcome of patients who had received radiotherapy alone. Between Jan 1995 and May 2001, 6 patients with low- grade MLS were treated with radiotherapy alone. The median radiation dose was 30.6 Gy (range; 30 - 39 Gy) in a daily fractions of 1.5 - 1.8 Gy. Each patient had an endoscopic esophago-gastro-duodenoscopy with biopsy, 4 weeks after the completion of radiotherapy and every 6 months thereafter. A complete response was obtained in all patients. All patients were followed-up without evidence of disease, and no patient suffered a relapse. There was neither perforation nor hemorrhage of the stomach in any of the patients. No renal or hepatic toxicity were noted, and no secondary malignancies developed. In conclusion, radiotherapy should be considered as the preferred treatment method for low-grade MLS, in patients with no evidence of H. pylori infection, or who do not respond to antibiotic therapy, due to the significant benefits in gastric preservation and low morbidity.
Adult ; Aged ; Female ; Human ; Lymphoma, Low-Grade/*radiotherapy ; Lymphoma, Mucosa-Associated Lymphoid Tissue/*radiotherapy ; Male ; Middle Age ; Radiotherapy/adverse effects ; Stomach Neoplasms/*radiotherapy