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Kerdsin A.,National Institute of Health | Uchida R.,Osaka University | Verathamjamrus C.,Japan National Institute of Public Health | Puangpatra P.,Japan National Institute of Public Health | And 7 more authors.
Japanese Journal of Infectious Diseases | Year: 2010

Although Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella spp. are prevalent causes of community-acquired pneumonia, rapid and sensitive diagnosis is difficult. Realtime PCR provides rapid and sensitive diagnosis, however, DNA extraction is still required, which is time-consuming, costly and includes a risk of contamination. Therefore, we aimed to develop triplex real-time PCR without DNA extraction. AmpDirect® Plus which inhibits PCR inhibitors was used as the PCR buffer. Melting temperatures of the PCR products for the three bacteria were analyzed by SYBR green triplex real-time PCR and were found to be significantly different. Detection limits of bacteria cells diluted in nasopharyngeal aspirates (NPAs) were comparable with the detection limits of previously reported real-time PCR. Our PCR without DNA extraction and probe real-time PCR with DNA extraction showed identical results for the detection of the three bacteria from 38 respiratory specimens (sputum, endotracheal aspirates, and NPAs) collected from patients with pneumonia. No cross-reaction with other bacteria was observed. Our triplex real-time PCR successfully detected and differentiated the three bacteria. Although further field tests are required, our assay is a promising method for the rapid and cost-effective detection of the three bacteria.


Tangjitgamol S.,Bangkok Metropolitan Administration Medical College and Vajira Hospital
Cochrane database of systematic reviews (Online) | Year: 2010

Interval debulking surgery (IDS), following induction or neoadjuvant chemotherapy, may have a possible role in treating advanced epithelial ovarian cancer (stage III to IV) where primary debulking surgery is not an option. To assess the effectiveness and complications of IDS for patients with advanced stage epithelial ovarian cancer. We searched the Cochrane Gynaecological Cancer Group's Specialised Register to July 2009, the Cochrane Central Register of Controlled Trials (CENTRAL) Issue 2, 2009, MEDLINE from January 1966 to June week 4 2009, and EMBASE from January 1966 to week 27 2009. Randomised controlled trials (RCTs) comparing survival of women with advanced epithelial ovarian cancer, who had IDS performed between cycles of chemotherapy after primary surgery with survival of women who had conventional treatment (primary debulking surgery and adjuvant chemotherapy). Two review authors independently assessed trial quality and extracted data. Searches for additional information from study authors were attempted. Meta-analysis of overall and progression-free survival (PFS) were performed using random-effects models. Three RCTs randomising 853 women, of whom 781 were evaluated, met the inclusion criteria. Meta-analysis of three trials for overall survival (OS) found no statistically significant difference between IDS and chemotherapy alone (hazard ratio (HR) = 0.80, 95% confidence interval (CI) 0.61 to 1.06, I(2) = 58%). Subgroup analysis for OS in two trials, where the primary surgery was not performed by gynaecologic oncologists or was less extensive, showed a benefit of IDS: HR = 0.68, 95% CI 0.53 to 0.87, I(2) = 0%). Meta-analysis of two trials for progression-free survival (PFS) found no statistically significant difference between IDS and chemotherapy alone (HR = 0.88, 95% CI 0.57 to 1.33, I(2) = 83%). Rates of toxic reactions to chemotherapy were similar in both arms (risk ratio = 1.19, 95% CI 0.53 to 2.66, I(2) = 0%), but little information was available for other adverse events or quality or life. No conclusive evidence was found to determine whether IDS between cycles of chemotherapy would improve or decrease the survival rates of women with advanced ovarian cancer, compared with conventional treatment of primary surgery followed by adjuvant chemotherapy. IDS appeared to yield benefit only in patients whose primary surgery was not performed by gynaecologic oncologists or was less extensive. Data on QoL and adverse events were inconclusive.


Srijaipracharoen S.,Gynecologic Oncology Unit | Tangjitgamol S.,Gynecologic Oncology Unit | Tangjitgamol S.,Bangkok Metropolitan Administration Medical College and Vajira Hospital | Tanvanich S.,Bangkok Metropolitan Administration Medical College and Vajira Hospital | And 5 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2010

Objective: To determine any association between expression of estrogen receptor (ER), progesterone receptor (PR), and Her-2/neu and clinicopathological features, including survival, of endometrial carcinoma (EMC) patients. Methods: Samples of formalin-fixed, paraffin-embedded tissue of 108 patients with EMC treated at our institution between January 1994 and December 2007 were immunohistochemically studied. Results: ER, PR, and Her-2/neu expression were positive in 59.3%, 65.7% and 2.8% of cases, respectively. Positive ER expression was significantly associated with grade I-II tumor while PR expression was linked with endometrioid histology, grade I-II tumor, less myometrial invasion (MI) and negative lymph node involvement. Her-2/neu expression was significantly associated with deep MI, while positive ER and negative Her-2/neu expression in combination was significantly associated with longer disease-free and overall survival. Conclusion: ER expression is a good prognostic factor while Her-2/neu expression appears to be a poor indicator for both disease-free and overall survival, while PR tended to show favorable influence for only disease-free survival of Thai EMCs.


Tangjitgamol S.,Bangkok Metropolitan Administration Medical College and Vajira Hospital | Manusirivithaya S.,Bangkok Metropolitan Administration Medical College and Vajira Hospital | Srijaipracharoen S.,Bangkok Metropolitan Administration Medical College and Vajira Hospital | Khunnarong J.,Bangkok Metropolitan Administration Medical College and Vajira Hospital | And 4 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2010

Objective: To assess the characteristic features, treatment, survival, and prognostic factors of Thai endometrial cancer (EMC) patients. Methods: Clinico-pathological data of EMC patients who were treated in the institution from 1992 to 2008 were collected. Survival rates and prognostic factors were studied. Results: The mean age of the 261 patients was 55.4 ± 9.92 years. The most common complaint was abnormal uterine bleeding (87.3%). More than half (75.4%) had other medical illnesses or other cancers (10.7%). The majority (78%) had early stage disease. Post-operative adjuvant therapy was given in 41.4%; the most common was radiation therapy (37.2%). From a median follow-up of 57.5 months (range 0.03-212.3 months), progressive disease was encountered in 16 patients. Eighteen experienced recurrence (three local, 13 distant metastases and two local and distant). Overall, 30 patients died of cancer, while 18 died of other medical illnesses. The 5-year progression-free, cancer specific, and overall survivals (95% confidence intervals) were 86.5% (82.1-90.8%), 88.0% (83.9-92.2%), and 83.6% (78.7-88.4%), respectively. Significant prognostic factors for survival were: histology, grade, depth of myometrial invasion, cervical involvement, lymphovascular invasion, lymph node status, and Her-2/ neu expression. Conclusion: Most endometrial cancer patients in Thailand present at early stages and experience good survival outcomes.

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