Muhammad Mansyur Romi

Histochemical and Immunohistochemical Study of α-SMA, Collagen, and PCNA in Epithelial Ovarian Neoplasm

Background: Alpha-smooth muscle actin (α-SMA) is an isoform of actin, positive in myofibroblasts and is an epithelial to mesenchymal transition (EMT) marker. EMT is a process by which tumor cells develop to be more hostile and able to metastasize. Progression of tumor cells is always followed by cell composition and extracellular matrix component alteration. Increased α-SMA expression and collagen alteration may predict the progressivity of ovarian neoplasms. Objective: The aim of this research was to analyse the characteristic of α-SMA and collagen in tumor cells and stroma of ovarian neoplasms. In this study, PCNA (proliferating cell nuclear antigen) expression was also investigated. Methods: Thirty samples were collected including serous, mucinous, endometrioid, and clear cell subtypes. The expression of α-SMA and PCNA were calculated in cells and stroma of ovarian tumors. Collagen was detected using Sirius Red staining and presented as area fraction. Results: The overexpressions of α-SMA in tumor cells were only detected in serous and clear cell ovarian carcinoma. The histoscore of α-SMA was higher in malignant than in benign or borderline ovarian epithelial neoplasms (105.3±129.9 vs. 17.3±17.1, P=0.011; mean±SD). Oppositely, stromal α-SMA and collagen area fractions were higher in benign than in malignant tumors (27.2±6.6 vs 20.5±8.4, P=0.028; 31.0±5.6 vs. 23.7±6.4, P=0.04). The percentages of epithelial and stromal PCNA expressions were not significantly different between benign and malignant tumors. Conclusion: Tumor cells of serous and clear cell ovarian carcinoma exhibit mesenchymal characteristic as shown by α-SMA positive expression. This expression might indicate that these subtypes were more aggressive. This research showed that collagen and α-SMA area fractions in stroma were higher in benign than in malignant neoplasms.

Strain Gauge Sensors Implemented in a New Female Torso Model Have Increased Student's Motivation and Confidence in Gynecologic Bimanual Examination on Clinical Skill Training

A good mannequin is needed to improve the quality of clinical skill learning. A strain sensors gauge can be applied into gynecologic bimanual examination mannequin. This study compared a new strain gauge sensors mannequin and non-sensor mannequin for gynecologic bimanual examination training in undergraduate medical student. We made a new female torso model implemented with strain gauge sensors in the definitive landmark, then used this new mannequin for gynecologic bimanual examination training in undergraduate medical student, and evaluated using questioner. We observed 4 parameters: mannequin appearance, student’s self confidence to palpate uterus and ovary, and student’s learning motivation. The new model improved student’s confident to palpate ovary (p<0.05) and student’s motivation (p<0.001) compared to non-sensor mannequin. In contrast, the gross appearance of the new mannequin was inferior (p<0.05). However, there was no difference in defining the uterus position during examination (p>0.05) in both mannequins. A new female torso model with strain gauge sensors can be applied for gynecologic examination training.