Comparative genomic hybridization (CGH) of augmentation cystoplasties

OBJECTIVE: Tumors arising within augmentation cystoplasties are aggressive, have poor prognosis and the majority are not detected at follow-up cystoscopy. Genetic changes in tumors precede morphological abnormalities. Therefore, the aim of this study was to investigate whether genetic abnormalities detected by comparative genomic hybridization (CGH) could be used to identify those patients with augmentation cystoplasties at increased risk of tumorigenesis. METHODS: Bladder biopsy samples were obtained from 16 augmentation cystoplasty patients both distant from and near to the enterovesical anastomosis. CGH was used to detect genetic abnormalities in DNA extracted from the biopsies, archival specimens of two augmentation cystoplasties and two de novo bladder adenocarcinomas. RESULTS: A greater number of amplifications on 2p, 3q, 8q, 9p, 17p, 18pq and 20pq, were observed in bladder biopsies obtained near to the enterovesical anastomosis compared to those taken distant to the suture line. CGH of archival augmentation cystoplasty tumor DNA indicated abnormalities at several loci with amplifications at 2q, 5q, 10p and 21pq, while deletions occurred at 5p and 16p. CONCLUSIONS: The results of this study suggest that the urothelium adjacent to the bladder and/or bowel anastomosis in augmentation cystoplasties is genetically unstable. Furthermore, longitudinal studies are required to establish whether or not patients exhibiting genetic instability following augmentation cystoplasty are at greater risk of developing tumors than those with genetically stable epithelia.     

Early imaging in heart failure: Exploring novel molecular targets

Conclusions  Noninvasive imaging of neurohumoral upregulation in remodeled myocardium suggests that an imaging strategy can be developed for predicting the rate of remodeling and likelihood of HF development. This should allow a more judicious use of neurohumoral antagonists especially in subjects who do not have manifest HF.⁷⁴ In others specific targeted imaging may allow timely selection of individualized treatment strategies and ensure optimization of therapeutic intervention. Similar to ACE and AII receptors, multiple other targets in the hormonal cascades can identify the likelihood of adverse and favorable remodeling.⁷⁴     

Die Rolle der Zytokine bei Knorpeldefekten und in der Knorpeltherapie

Cytokines play a pivotal role in the pathogenesis of degenerative joint disease but also in inflammatory conditions as well as osteoarthritis (OA) and rheumatoid arthritis (RA). A key role is attributed to interleukin-1 and tumor necrosis factor-α. Certain cytokines that can inhibit the activity of catabolic cytokines have great therapeutic potential and are currently being investigated in numerous clinical studies. Available scientific findings indicate that proinflammatory cytokines stimulate cartilage breakdown and blockade of these cytokines can protect the cartilage.     

Managing catheter dysfunction for better patient outcomes: a team approach.

Vascular access is the leading cause of morbidity in the hemodialysis patient population. Arteriovenous fistulas (AVFs) have the lowest complication rate while catheters have the highest. Though significant effort is being made to increase the number of AVFs and lower the number of catheters, annual data show that the number of catheters is increasing. To improve vascular access-related patient outcomes, catheter dysfunction needs to be managed by a vascular access team using the CQI process that begins with a comprehensive algorithm for treatment.