2.Correlation of p16INK4a immunoexpression and human papillomavirus (HPV) detected by in-situ hybridization in cervical squamous neoplasia
Cheah PL ; Koh CC ; Nazarina AR ; Teoh KH ; Looi LM
The Malaysian Journal of Pathology 2016;38(1):33-38
Persistence and eventual integration of high-risk HPV (hrHPV) into the cervical cell is crucial
to the progression of cervical neoplasia and it would be beneficial to morphologically identify
this transformation in routine surgical pathology practice. Increased p16INK4a (p16) expression is a
downstream event following HPV E7 binding to pRB. A study was conducted to assess the correlation
between hrHPV detection using a commercial in-situ hybridization assay (Ventana INFORM HPV
ISH) and p16 immunoexpression (CINtec Histology Kit) in cervical squamous intraepithelial lesions
and squamous carcinoma. 27 formalin-fixed, paraffin-embedded cervical low-grade squamous
intraepithelial lesions (LSIL), 21 high-grade squamous intraepithelial lesions (HSIL) and 51 squamous
carcinoma (SCC) were interrogated. hrHPV was significantly more frequent in HSIL (76.2%) and
SCC (88.2%) compared to LSIL(37.0%). p16 expression was similarly more frequent in HSIL
(95.2%) and SCC (90.2%) compared to LSIL(3.7%). That the rates of hrHPV when compared with
p16 expression were almost equivalent in HSIL and SCC while p16 was expressed in only 1 of the
10 LSIL with hrHPV, are expected considering the likelihood that transformation has occurred in
HSIL and SCC but does not occur in majority of LSIL.
3.Superior somatic pain relief and improved visceral pain control is achieved using pre-emptive analgesia for laparoscopic cholecystectomy: a randomized controlled trial
Koh PS ; Cha KH ; Lucy C ; Rampal S ; Yoong BK
Journal of University of Malaya Medical Centre 2012;15(2):1-7
BACKGROUND:
Laparoscopic cholecystectomy, although is less invasive than open surgery, is not completely pain free. The
use of local anaesthesia to relieve pain following this procedure is a common practice. However, it remains
debatable whether a pre- or post-operative drug administration is more effective. Here, we investigated
the role of preemptive local anaesthetic infiltration given pre- or post-incisional, in relieving the pain during
laparoscopic surgery.
METHODOLOGY:
A randomized controlled trial was conducted with 96 patients receiving 0.5% Bupivacaine 100mg. Group
A (n=48) received post-incisional skin infiltration whilst Group B (n=48) received pre-incisional infiltration.
Incisional (somatic) and intra-abdominal (visceral) pain was assessed using Visual Analog Scale (VAS) at day
0, day 1 and day 7 post-operative days.
RESULT:
Baseline characteristics between the two groups were similar. Incisional pain was lower in Group B as compared
to Group A at day 0 (P=0.03) and day 1 (P<0.01). Intra-abdominal pain was also lower in Group B at day 0 and
day 1 (P= 0.04). VAS score was similar at day 7 although analgesia requirement is higher in Group A (P>0.05).
CONCLUSION:
Administration of pre-incisional local anaesthesia offers better pre-emptive pain relief measure than postincisional
administration by reducing somatic and visceral pain in laparoscopic gall bladder surgery.
Cholecystectomy, Laparoscopic