Relationship between toll-like receptor 2 nonsynonymous single nucleotide polymorphisms and the effectiveness of Bacille Calmette-Guérin immunotherapy in preventing recurrence of superficial bladder cancer: A prospective study

Background: Intravesical Bacille Calmette-Guérin (BCG) immunotherapy has been used for several decades as a prophylactic approach against recurrence of superficial bladder cancer. However, its effectiveness has been both variable and unpredictable. Typically, cancer BCG-immunotherapy aims to redirect or modulate both innate and adaptive immune responses. The consequences of gene polymorphisms in several key immuno-regulatory molecules on the heterogeneity of the response to BCG-immunotherapy have been investigated.Objective: The aim of this study was to evaluate the association of toll-like receptor (TLR) 2 polymorphisms (arginine to glutamine substitution at position 753 [Arg753Gln] and arginine to tryptophan substitution at position 677 [Arg677Trp]) and the outcome of BCG-immunotherapy.Methods: This prospective study was conducted during a 3-year period from June 2006 to July 2009. Consecutive patients were recruited during a 1-year period and followed for 2 years at the Department of Urology, Charles Nicolle Hospital, Tunis, Tunisia. Patients with superficial bladder tumors at stage Ta (noninvasive papillary carcinoma) or T1 (where the tumor has grown from the layer of cells lining the bladder into the connective tissue below but has not grown into the muscle layer of the bladder) of any grade were eligible; carcinoma in situ cases were excluded. The TLR2 Arg753Gln and Arg677Trp polymorphisms were studied in peripheral blood DNA from patients treated with BCG-immunotherapy after transurethral resection.Results: A total of 112 consecutive patients were enrolled (101 men and 11 women; mean age, 63.9 years [range, 25–85 years]) and completed the 2-year followup. Polymerase chain reaction amplification followed by direct sequencing of the region containing the TLR2 single-nucleotide polymorphism (SNP) of interest did not detect Arg753Gln or Arg677Trp in any of the study participants belonging to either of 2 groups: responders (n = 67) and nonresponders (n = 45) to BCG-immunotherapy.Conclusions: No patients included in the study were found to have the 2 known TLR2 nonsynonymous SNPs, and the relative importance of these polymorphisms could not be definitely determined. However, a significant proportion of patients without these polymorphisms responded to BCG-immunotherapy, suggesting that these genetic variants are not critical in the effectiveness of this approach for preventing recurrence of the tumor.     

Bcl-2 expression and triple negative profile in breast carcinoma

Appearance of non-Hodgkin’s lymphomas (NHL) and renal cell carcinoma (RCC) in same person has been reported in the literature. There is a higher-than-expected incidence of co-occurrence of these neoplastic disorders. The cause for this association remains speculative. Two epidemiological studies have shown that the observed-to-expected ratio for occurrence of RCC in NHL patients were 1.86 to 2.67. We herein describe five patients with both RCC and lymphoid malignancies, and reviewed possible explanations for the association. In three of the five patients, RCC was diagnosed during lymphoproliferative disease work-up, and remaining two cases had been diagnosed with chronic lymphocytic leukemia 1 and 5 years prior to RCC. All RCC cases were detected during staging of the primary tumor, usually by CT scan and/or ultrasound. Our data are in correlation with the literature that there is an increased association of RCC and NHL more often among male patients, and that the lymphoproliferative disease often presents with extranodal involvement. The specialists should be alerted for this possibility when evaluating patients at diagnosis or during follow-up.     

REVIEW ARTICLE: Paediatric nasopharyngeal rhabdomyosarcoma: A case series and literature review

Rhabdomyosarcoma (RMS) is the most common soft tissue tumour in children, with the head and neck region accounting for 35–40% of cases. Nasopharyngeal RMSs tend to grow rapidly and invade adjacent structures. Both the Intergroup Rhabdomyosarcoma Studies and the European Studies have established that the ideal management of this disease is multimodal, using a combination of surgery, chemotherapy and radiotherapy. This case series examines the role of radiotherapy in the management of paediatric nasopharyngeal RMSs, with particular reference to long-term morbidity and disease-free survival. The cases of five children with nasopharyngeal RMS were reviewed and a systematic review of the literature contained in the PubMed databases was conducted to establish 24 individually detailed cases. Management in all patients was multimodal, using a combination of chemotherapy, radiotherapy as well as surgery. External beam radiotherapy is an integral component of treatment for nasopharyngeal RMSs. With more patients surviving for longer periods, more long-term sequelae of radiotherapy have been reported. Complications include sensorineural deafness, endocrine manifestations following radiation of the pituitary gland, cranial nerve palsies, second malignancies within the radiation field, cataract formation, retinopathy and growth disturbance. Morbidity from radiotherapy may be considerable and depends on the field and dose of radiation. Current advances in radiotherapy are aimed at improving the rate of tumour control and reducing such complications. Recent improvements in imaging and conformal techniques have the potential to reduce the morbidity associated with radiotherapy in this cohort.     

Editorial – A parliamentary spotlight on prevention

It can be a disconcerting experience as a health promoter when the question comes up “So …what do you do”. In reply you might say: “I manage health promotion projects”, or “I am a health promotion researcher”. The smile that you receive indicates that your interlocutor likes the sentiment of what you are saying, but the quizzical furrow on her or his brow suggests a lack of certainty about what it is you mean. If you are in the mood you might go on to discuss what health promotion is all about, but the experience serves as a reminder that it is not a widely recognised field of work. But things may be changing. The reports of the Preventive Health Task Force and the debate around the Australian National Preventive Health Agency (ANPHA) Bill 2009 in Parliament have brought an unprecedented level of attention to our field. The Hansard related to the ANPHA Bill provides a window into how our elected leaders understand health promotion and whether they consider a greater investment in this endeavour to be worthwhile.     

超早期小骨窗开颅治疗基底节区高血压脑出血

目的探讨超早期小骨窗开颅治疗基底节区高血压脑出血（hypertension intracerebral hemorrhage,HIH）的临床效果。方法对我院2007年9月～2009年12月采用超早期小骨窗开颅手术治疗的基底节区HIH58例临床资料进行回顾性分析。结果本组术后生存56例,死亡2例。术后随访6个月,根据日常生活能力评分,Ⅰ级9例,Ⅱ级15例,Ⅲ级23例,Ⅳ级9例。结论超早期小骨窗开颅治疗基底节区HIH创伤小,直视下血肿清除彻底,止血确切,能较迅速降低颅内压,防治脑水肿。     

Coronary angiogram video compression for remote browsing and archiving applications

In this paper, we propose a H.264/AVC based compression technique adapted to coronary angiograms. H.264/AVC coder has proven to use the most advanced and accurate motion compensation process, but, at the cost of high computational complexity. On the other hand, analysis of coronary X-ray images reveals large areas containing no diagnostically important information. Our contribution is to exploit the energy characteristics in slice equal size regions to determine the regions with relevant information content, to be encoded using the H.264 coding paradigm. The others regions, are compressed using fixed block motion compensation and conventional hard-decision quantization. Experiments have shown that at the same bitrate, this procedure reduces the H.264 coder computing time of about 25% while attaining the same visual quality. A subjective assessment, based on the consensus approach leads to a compression ratio of 30:1 which insures both a diagnostic adequacy and a sufficient compression in regards to storage and transmission requirements.