Resection for extrahepatic recurrence of hepatocellular carcinoma

A total of 277 patients with hepatocellular carcinoma (HCC) underwent hepatic resection over a 20-year period. Twelve of 36 patients with recurrence confined to extrahepatic organs underwent surgical resection. There were no complications but one patient died in hospital from secondary intrahepatic recurrence. The 1-, 2- and 5-year survival rates for these 12 patients after hepatic resection were 92, 52 and 26 per cent respectively and were better than those of 24 patients who did not undergo resection for recurrence. The mean survival following resection for recurrent disease was 19.7 months and the longest survival time was nearly 8 years. Secondary recurrence after resection of metastases developed more commonly in the liver than in extrahepatic organs. Among the eight patients who survived for more than 4 months after the second operation, secondary recurrence developed in the liver and extrahepatic organs in eight and four patients respectively. In selected patients with isolated extrahepatic recurrence of HCC, surgery is effective in controlling extrahepatic disease and offers the only chance of long-term survival.     

Meta-analyses of studies of the diagnostic accuracy of laboratory tests: a review of the concepts and methods

OBJECTIVE: To provide practicing pathologists and other laboratory professionals with the necessary background for reading and evaluating published reports of meta-analyses of studies of the diagnostic accuracy of laboratory tests. STUDY SELECTION: English language literature, 1980 to present, pertaining to the rationale, objectives, and interpretation of meta-analyses of randomized controlled trials, and meta-analyses of studies of the diagnostic accuracy of laboratory tests. CONCLUSIONS: Meta-analysis has several applications in the investigation of the diagnostic accuracy of laboratory tests. It can improve the quality of future primary studies by drawing attention to the methodologic deficiencies of existing reports; it can identify reasons for the variation in the results of those reports; and it can generate valid summary estimates of the diagnostic accuracy of laboratory tests based on all completed investigations, providing that the available primary studies are of high scientific validity. Several statistical techniques for integrating data from reports on diagnostic test accuracy have either been developed or are under development, but meta-analysis is often limited by the poor quality of the primary studies and the effect of publication bias. Meta-analysis can evolve into a reliable tool for assessing the accuracy of laboratory tests if both investigators and editors strive to improve the quality of the primary studies and to reduce the extent of publication bias in this area of the literature.     

Treasures amongst the trash: functional RNAs within introns

Health care professionals are interested in practical definitions that provide solutions to problems. There are many advantages to defining chemical dependence as a disease. This paper gives a health care professional clear directions regarding identifying the problem of chemical dependence and specifying a specific treatment plan for patients. We review the issues of personal responsibility, the moral model of addictions, and the neuropharmacology of the disease process, and advocate for the disease model as an effective, practical method for treating alcoholism and drug dependence.     

Using dry feed intake as a percentage of initial body weight as a weaning criterion

Newborn Holstein heifers (n = 32) and bulls (n = 12) were used to investigate the use of dry feed intake as a percentage of birth weight as a weaning criterion. Three different percentages (1, 1.5, and 2%) were used. Calves in the 1% treatment group met the weaning criterion earlier than did those in the 1.5 and 2% treatment groups; no difference was detected between the latter two groups. Total dry feed intake at 8 wk was higher for calves in the 1% treatment group than for calves in the other treatment groups; no difference was detected between the 1.5 and 2% treatment groups. Weights for all calves at 8 wk and weights of heifer calves at 12, 16, and 20 wk were not different among groups. Using dry feed intake at 1% of birth weight as a weaning criterion reduced days to weaning, increased dry feed intake from birth to 8 wk, decreased variation in weaning age, and had no apparent negative effect on growth at 20 wk of age. Using dry feed intake as a percentage of birth weight appears to be a suitable criterion to determine when to wean dairy calves.     

Poisoning of dairy heifers by mercurous chloride

Mercury poisoning was diagnosed in four dairy heifers, three of which died. The clinical signs were variable and included salivation, excessive thirst, extreme depression and severe diarrhoea. Postmortem examinations revealed inflammation and ulceration of the alimentary tract, pulmonary and cardiac haemorrhages, pallor of the kidney cortices and perirenal oedema. The kidney mercury concentrations were in the range 58 to 91 micrograms/g wet tissue. It is believed that the animals were poisoned by the ingestion of soil contaminated with mercurous chloride.     

Inhibition of PCR amplification by a point mutation downstream of a primer

A T-->C point mutation is shown to specifically inhibit PCR amplification when compared to wild-type controls in exon H of the factor IX gene. Multiple primers of different lengths and locations were designed to examine this phenomenon. The experiments suggest that poor annealing and/or extension from the downstream primer are responsible for the observed inhibition and that the mutation can exert an inhibitory effect upon PCR amplification at a distance of at least 84 bp. The inhibition was not alleviated when amplification conditions such as annealing temperature, time of extension, type of DNA polymerase or concentration of DNA template, primer or DNA polymerase were varied. The inhibitory factor(s) are likely to be contained within the amplified segment itself because neither the use of a previously amplified PCR product as template for nested PCRs nor the restriction enzyme digestion of that previously amplified product relieved the inhibition of PCR amplification in the mutant sample. Computer analyses with the FOLDRNA and FOLDDNA programs did not reveal the mechanism of inhibition. Although dramatic inhibition, as shown here, may be uncommon, more subtle inhibition may be frequent. Documentation of differential amplification caused by a single-base substitution in template sequence has implications for certain commonly used PCR-based methods such as quantitative PCR, differential display and DNA fingerprinting. In addition, heterozygous single-base pair mutations down-stream of a primer may be missed if the PCR is inhibited; alternatively; the mutation may appear to be homozygous if amplification of the mutated allele is selectively enhanced.