Microsatellite instability and aneuploidy rate in young colorectal-cancer patients do not differ significantly from those in older patients

DNA and chromosomal instabilities are thought to promote colorectal carcinogenesis. Mismatch repair (MMR) deficiency affects DNA-sequence integrity, resulting in microsatellite instability (MI). Tumor aneuploidy (AN) has been shown to reflect underlying chromosomal instability (CI). This study aimed at assessing the MI and AN rate of Singapore's colorectal-cancer (CRC) patients, who are predominantly Chinese, in association with age group, tumor site, Dukes' staging and gender. In contrast to a Caucasian series, the MI rate for our younger patients aged 40 or less without family history (23%) is not significantly different from that for older, sporadic patients (13%) aged 60 or more, suggesting that population screening for germline MMR mutations is unlikely to be cost-effective. Our MI-positive patients also show no significant differences from the MI-negative patients with respect to tumor site, staging, ploidy status and gender. This implies that the local MI-positive individuals may have a different profile from that of the Caucasians, indicating the possibility of underlying genetic differences. AN is also not significantly more prevalent in younger patients. In addition, a significant 21% of our patients (p < 0.00005) show no evidence of either the MI or CI pathways, implying that there is at least a third pathway driving colorectal carcinogenesis, involving neither genes that maintain DNA sequence stability nor genes that cause gross chromosomal segregation defects.     

In utero intestinal volvulus presenting as neonatal emergency

A case of in utero intestinal volvulus with haemoperitoneum, diagnosed prenatally by ultrasonography is reported. The diagnostic technique enables planning and prompt management of acute abdomen.     

Transfer of TN916-like elements in microcosm dental plaques

Microcosm dental plaques were grown from an inoculum of human saliva in a constant-depth film fermentor. The inoculum contained four tetracycline-resistant streptococcal species, each of which contained a Tn916-like element. This element was shown to transfer to other streptococci both in filter-mating experiments and within the biofilms in the fermentor.     

Enterolith Formation in the Roux Limb Hepaticojejunostomy

Enterolith in the Roux limb of Roux-en-Y hepaticojejunostomy is rare. We report a case of a Roux loop enterolith presenting with recurrent cholangitis. Cholescintigraphy and magnetic resonance imaging aided in the preoperative diagnosis. Intraoperatively, a large enterolith was extracted distal to the biliodigestive anastomosis. A kink of the small bowel was also noted distal to the stone. The mechanism for enterolith formation in the Roux loop is discussed.     

Demographic and clinical characteristics of chronic prostatitis: prospective comparison of the University of Sciences Malaysia Cohort with the United States National Institutes of Health Cohort

PURPOSE: We compared demographic and clinical characteristics of the University of Sciences Malaysia Chronic Prostatitis Cohort to the United States National Institutes of Health Chronic Prostatitis Cohort. MATERIALS AND METHODS: Participants met the same definition of chronic prostatitis/chronic pelvic pain syndrome. Each participant had extensive demographic, medical history, previous treatment, clinical and laboratory evaluations. RESULTS: The University of Sciences Malaysia and National Institutes of Health cohorts proved similar in most respects. National Institutes of Health-Chronic Prostatitis Symptom Index total scores, pain and urinary subscores were similar for the 332 University of Sciences Malaysia Chronic Prostatitis Cohort and 488 National Institutes of Health Chronic Prostatitis Cohort participants. Differences included worse quality of life subscore for the University of Sciences Malaysia Chronic Prostatitis Cohort, differences in the location, number of sites, and types of pain/discomfort between the 2 populations, and that the University of Sciences Malaysia participants had received less previous treatment. CONCLUSIONS: The demographic characteristics and clinical presentation of chronic prostatitis/chronic pelvic pain syndrome proved remarkably similar in these diverse populations. Both cohorts experienced major reduction in their quality of life from chronic pelvic pain and urinary symptoms. Comparison of diverse populations using standard clinical, laboratory and assessment instruments is feasible, and may provide important insights into chronic prostatitis/chronic pelvic pain syndrome and the factors that determine clinical outcome.