Prognostic-significance of chromosome 5q and 17p allelic deletion in colorectal adenocarcinomas

Patient survival was analysed for 75 patients after surgery for primary colorectal adenocarcinoma with regards to allelic loss of chromosome 17p and chromosome 5q. Allelic loss of chromosome 17p occurred in 69% of patients and was not significantly associated with a poorer patient prognosis as assessed by log rank analysis of Kaplan-Meier survival plots (p = 0.161). Allelic loss of chromosome 5q occurred in 32% of patients and was significantly associated with a poorer patient prognosis as assessed by log rank analysis of Kaplan-Meier survival plots (p = 0.014). Analysis of the two variables by Cox regression analysis indicated that allelic loss of chromosome 5q was an independent variable for patient prognosis. Entry of Dukes' stage into the model resulted in a final model with Dukes' stage and allelic loss of chromosome 5q as independent significant variables in assessing patient survival. These results show that allelic loss of chromosome 5q, but not chromosome 17p provides additional prognostic information for assessing patient survival, over and above Dukes' stage.     

Incipient left ventricular rupture complicating anomalous left coronary artery

A 4-month-old girl presented with 2 weeks of symptoms and physical signs of heart failure. Echocardiography demonstrated marked left ventricular dilation, thinning of the myocardium with anterolateral akinesis, mitral regurgitation, a moderate pericardial collection, and an anomalous left coronary artery from the pulmonary artery. At operation there was a tense hemopericardium and a site of imminent rupture through a transmural anterior infarction. The anomalous artery was reimplanted in the ascending aorta, and an extensive infarct resection and ventricular repair performed. Support with a left ventricular assist device was required for 3 days, but the infant subsequently made a satisfactory recovery. Left ventricular rupture is a very rare complication of this lesion, but should be considered if there is evidence of a pericardial collection.     

Needlescopic or minisite cholecystectomy

Needlescopic or minisite cholecystectomy is laparoscopic cholecystectomy done through tiny ports from 1.4 mm to 3 mm in size. This refinement of conventional laparoscopic cholecystectomy reduces further the invasiveness of the operation and gives an improved cosmetic effect. This series describes the result of 36 needlescopic cholecystectomies done between February 1996 and April 1997. Patients with acute cholecystitis were excluded. There were two conversions to conventional laparoscopic surgery and no conversions to open surgery. Thirty-four patients were successfully treated by this technique. Analgesic consumption and cosmetic result was superior compared to a previous published series of conventionally done cases in the same department.     

PREVALENCE OF MICROALBUMINURIA IN NON-INSULIN-DEPENDENT DIABETES MELLITUS

The prevalence of microalbuminuria was assessed in 50 patients of non-insulin dependent diabetes mellitus. The mean age of patients was 52.1 ± 11.6 years and the duration of diabetes was 8.3 ± 6.8 years. Twenty (40%) patients had microalbuminuria. Microalbuminuria was more common in patients with a longer duration of diabetes (more than 5 years), a poor glycaemic control, and higher systolic blood pressure.KEY WORDS: Microalbuminuria, Diabetes mellitus, Diabetic nephropathy, Chronic renal failure     

Activity of subinhibitory concentrations of dapsone alone and in combination with cell-wall inhibitors againstMycobacterium avium complex organisms

MICs of dapsone (p-p-diaminodiphenylsulfone) were determined radiometrically for ten strains each of theMycobacterium avium complex (MAC) andMycobacterium tuberculosis. MICs ranged from 50 to 250 µg/ml forMycobacterium tuberculosis and from 2 to 100 µg/ml for MAC. However, at a concentration as low as 1.5 µg/ml dapsone significantly inhibited growth of MAC bacteria when used in combination with other drugs specifically acting at the mycobacterial cell-wall level. The latter drugs were used in subinhibitory concentrations, and includedm-fluorophenylalanine (an inhibitor of mycoside-C biosynthesis), ethambutol (an inhibitor of arabinogalactan biosynthesis), and ethionamide (an inhibitor of mycolic acid biosynthesis). Using a radiometric method (Bactec 460-TB), the activity of dapsone was found to be enhanced for 2/10 strains in the presence ofm-fluorophenylalanine, for 3/10 strains in the presence of ethambutol and for 5/10 strains in the presence of ethionamide. A satisfactory correlation between the radiometric data and bacterial viable counts was established.     

Is the retractile testis a normal,physiological variant or an anomaly that requires active treatment?

Conventional teaching states that the retractile testis is a normal, physiological variant that descends spontaneously by puberty and requires no active treatment. Critical review of the literature, however, suggests that this complacent view may be inappropriate. Substantial overlap exists between the three seemingly separate entities of the late descending, the ascending and the retractile testes. This overlapping group probably accounts for the recently observed increased incidence of orchidopexies. Retractile testes that spend most of the time in an extrascrotal position are subject to the same adverse effects of higher temperatures as true undescended testes, regardless of whether they can be manipulated into the scrotum; what matters is where they actually reside most of the time. The evidence suggests that such retractile testes suffer similar pathological changes to true undescended testes if left to await spontaneous descent. Evidence is presented to support a radical, novel proposal that the retractile testis is a variant of the spectrum of pathological maldescended testes and requires active treatment. A new strategy is proposed for the management of this common pathology. Correspondence to: D. W. Goh     

Cutting oil dermatitis on guinea pig skin

The effect of repeated exposure of cutting oil on 8 guinea pigs' skin was evaluated by visual scoring for erythema and skin water vapour loss (SVL) measurement over a 6-week period. The visual scores (measuring severity of erythema) and SVL values were significantly higher on skin treated with cutting oils (positive control) compared to untreated skin (negative control) throughout the study period. The scores and SVL values returned to near-baseline values when cutting oil application was stopped. In addition, the effect of 2 "after-work" emollient creams on 8 guinea pigs' skin repeatedly treated with a cutting oil was assessed by similar methods. The visual scores and SVL values of guinea pig skin that was repeatedly treated with the cutting oil and moisturized with "after-work" emollient creams, were significantly higher than negative and positive control guinea pig skin. It appeared that the 2 "after-work" emollient creams do not alleviate the irritant effect of the cutting oil on guinea pig skin. They appeared to aggravate the irritant effect of the cutting oil.