Chromosomal abnormalities in human retinoblastoma. A review

In part because of an association between the tumor and the constitutional chromosome 13q deletion syndrome and the finding of 13q deletions or monosomy 13 in retinoblastoma cells from individuals with normal constitutional karyotypes, chromosome 13q is postulated to contain a gene responsible for tumorigenesis in retinoblastoma. A review of the cytogenetics of retinoblastoma (incorporating an analysis of five previously unpublished cases and 77 cases from the literature) revealed recurrent abnormalities (in addition to those involving number 13, 21% of cases) that included: additional copies of 1q material (44%), isochromosome (6p) (45%), monosomy 16 (18%), marker 1p+ (13%), and homogeneously staining regions and double minutes (9%). Possible roles for these chromosome abnormalities in tumor development are discussed.     

Cardiac troponin levels in heart failure

Congestive heart failure (CHF) is a major cardiovascular disorder that is increasing in incidence, prevalence, and lethality. The prognostic significance of cardiac troponin levels among symptomatic and asymptomatic CHF has attracted recent interest. We sought to assess the significance of cardiac troponins in heart failure. These cardiac markers are associated with decreased left ventricular ejection fraction and poor prognosis in patients with CHF and are related to the severity of heart failure. The mechanism for the release of these markers seems to be from ventricular remodeling, ongoing myocyte degeneration, the presence of coronary artery disease, and reduced coronary reserve. In addition to B-type (brain) natriuretic peptide (BNP), cardiac troponin levels measured in patients admitted to the hospital could help risk-stratify patients and manage them effectively. BNP and cardiac troponins are easy to measure and can be repeated many times to follow patients, without interobserver variability. Theoretically, BNP is a marker of heart failure status and cardiac troponin is a marker of myocyte injury. The first therapeutic goal could be relief of circulatory congestion and lowering of BNP. The second goal could be attenuation of myocyte injury and lowering of cardiac troponins. Measuring and monitoring the levels of both could be highly effective means to reliably stratify the patients into low-, intermediate-, and high-risk groups for cardiac events and progression of heart failure. Furthermore, large-scale trials are necessary to establish them as noninvasive monitoring markers of heart failure and effectiveness of treatment.     

Effect of the rate of delivery of lignocaine gel on patient discomfort perception prior to performing flexible cystoscopy

Flexible cystoscopy is commonly performed under local anaesthesia. Instillation of lignocaine gel is commonly associated with urethral discomfort, which in some cases results in fierce opposition to further flexible cystoscopy under local anaesthesia. Although studies have demonstrated that the temperature of lignocaine can influence the level of discomfort experienced, to date no study has investigated the influence of the rate of lignocaine delivery on perceived discomfort. We therefore performed a prospective, randomised study to investigate this in patients undergoing flexible cystoscopy. One hundred consenting men were randomised to receive 11 ml of 2% lignocaine hydrochloride gel over either 2 or 10 s. The groups were well matched for age. After instillation of the gel, the patients were immediately asked to score their discomfort using a visual analogue scale. The discomfort experienced by patients that received the gel over 10 s was significantly (p < 0.05; Student's t test) less than those that received it over 2 s. This was irrelevant of the age of the patient and the number of previous cystoscopies performed. We have demonstrated that slow administration results in decreased discomfort. This may, in turn, reduce the need to resort to general anaesthesia, which is associated with increased morbidity and cost.     

Assessment of the Utility of Kidney Histology as a Basis for Discarding Organs in the United States: A Comparison of International Transplant Practices and Outcomes

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Sporadic Burkitt lymphoma of the jaw: Case report and review of the literature

Sporadic Burkitt lymphoma of the jaw is a rare neoplasm with an exceedingly fast doubling rate. This article presents a case of sporadic Burkitt lymphoma initially managed as an odontogenic infection. The early radiographic features and histologic criteria are discussed. Burkitt lymphoma should be considered in the differential diagnosis of any rapidly expanding or swelling jaw masses in young patients. (Quintessence Int 2012;43:333?336).