Background: Synovial sarcoma (SS) is a rare cancer and accounts for 5-10% of adult soft tissue sarcomas. Making an accurate diagnosis is difficult due to the overlapping histological features of SS with other types of sarcomas and the non-specific immunohistochemistry profile findings. Molecular testing is thus considered necessary to confirm the diagnosis since more than 90% of SS cases carry the transcript of t(X;18)(p11.2;q11.2). The purpose of this study is to diagnose SS at molecular level by testing for t(X;18) fusion-transcript expression through One-step reverse transcriptase real-time Polymerase Chain Reaction (PCR). Method: Formalin-fixed paraffin-embedded tissue blocks of 23 cases of soft tissue sarcomas, which included 5 and 8 cases reported as SS as the primary diagnosis and differential diagnosis respectively, were retrieved from the Department of Pathology, Tengku Ampuan Afzan Hospital, Kuantan, Pahang. RNA was purified from the tissue block sections and then subjected to One-step reverse transcriptase real-time PCR using sequence specific hydrolysis probes for simultaneous detection of either SYT-SSX1 or SYT-SSX2 fusion transcript. Results: Of the 23 cases, 4 cases were found to be positive for SYT-SSX fusion transcript in which 2 were diagnosed as SS whereas in the 2 other cases, SS was the differential diagnosis. Three cases were excluded due to failure of both amplification assays SYT-SSX and control β-2-microglobulin. The remaining 16 cases were negative for the fusion transcript. Conclusion: This study has shown that the application of One-Step reverse transcriptase real time PCR for the detection SYT-SSX transcript is feasible as an aid in confirming the diagnosis of synovial sarcoma.

Introduction:: During infection, there is increased expression of CALC-I gene resulting in ubiquitous release of procalcitonin (PCT). Since the expression of PCT is dependent on the genetic constituents of a population, this study aimed to validate the diagnostic performance of PCT in differentiating sepsis from noninfectious systemic inflammatory response syndrome (SIRS) in a Malaysian intensive care unit (ICU). Materials and Methods:: Ninety-five patients fulfilling the criteria for SIRS were enrolled. Daily concentrations of PCT, C-reactive protein (CRP) and white cell count (WCC) were measured over three days. The diagnostic and predictive performance of these biomarkers were assessed using area under the curve of the ROC. Results:: In this study, medical and surgical cohorts had similar PCT concentrations. Peak (p=0.02) and daily PCT (p<0.001) concentrations were significantly higher in patients with sepsis compared to SIRS. There were no significant differences in the CRP and WCC concentrations between the two groups. Peak PCT was significantly higher in patients with bacteraemia than those without (49.1 [19.3- 57] vs. 6.9 [1.1-25.6 ng/ml], p=0.001). PCT was diagnostic of sepsis and bacteraemia (AUC of 0.73 [0.64-0.83] and 0.80 [0.66-0.93] respectively). Peak PCT was significantly higher in septic patients with culture positive compared to culture negative (p=0.02). At the optimal cut-point of 10.68 ng/ml for peak PCT, sepsis was very likely with specificity of 86% and psotive predictive value (PPV) of 91%. There was a good correlation between PCT concentration and the Sequential Organ Failure Assessment (SOFA) score in the sepsis cohort (r=0.62, p<0.0001). Conclusion: PCT was better than CRP or WCC in differentiating sepsis from non-infectious SIRS in critically-ill patients. PCT is diagnostic of sepsis and bacteraemia, and is also useful as an indicator of severity of organ failure in sepsis.

Polymorphisms within the β2-adrenergic receptor (ADRB2) gene have been repeatedly linked to hypertension. Among the ADRB2 polymorphisms detected, Arg16Gly and Gln27Glu codons are considered the two most important variations. The amino acid substitution at these codons may lead to abnormal regulation of ADRB2 activity. The aim of the present study was to assess the association between ADRB2 polymorphisms and hypertension. This case-control study consisted of 100 unrelated subjects (50 hypertensive and 50 matched normal controls). Arg16Gly and the Gln27Glu polymorphisms were analyzed by polymerase chain reactionrestriction fragment length polymorphism assay. There were no significant evidence of association in allelic and genotypes distribution of Arg16Gly and Glu27Gln with blood pressure and hypertension. These findings suggest that the variation within codon 16 and 27 of ADRB2 gene were unlikely to confer genetic susceptibility for hypertension in our population samples.