Loss of heterozygosity and microsatellite instability in de novo versus ex-adenoma carcinomas of the colorectum

Small adenocarcinomas of the colorectum showing no evidence of origin from an adenoma have been called de novo carcinomas, a name that implies an origin via a different molecular genetic mechanism than the usual colorectal carcinoma which develops from an adenoma. Using microsatellite analysis, 35 early (pT1) de novo and 36 pT1 ex-adenoma carcinomas were compared using 8 microsatellite loci at 6 different chromosomal loci (1p, 2p, 8p, 5q, 17p, and 18q) known or hypothesized to be important for colorectal carcinogenesis. The rate of loss of heterozygosity (LOH) at the 17p locus (near the p53 gene) was significantly higher in the de novo than in the ex-adenoma group (73 vs. 37%, P = 0.004). The rates of LOH at the other loci (including the APC and DCC genes) and the rate of MSI were not significantly different in the two groups. These results indicate that de novo carcinomas of the colorectum develop via a similar carcinogenetic pathway as conventional ex-adenoma carcinomas; however, their higher rate of LOH at 17p is evidence for a biologically more advanced lesion with more frequent p53 mutations, consistent with clinicopathological data indicating that de novo carcinomas are more aggressive than ex-adenoma carcinomas.     

Bacterial and Ureaplasma colonization of the airway: radiologic findings in infants with bronchopulmonary dysplasia

OBJECTIVE: We designed this retrospective study to compare radiologic findings in premature infants with bronchopulmonary dysplasia (BPD) in whom gram-positive cocci (GPC), gram-negative bacilli (GNB), or Ureaplasma urealyticum were colonized. Another objective was to correlate the radiologic findings of these patients with the clinical severity of BPD. STUDY DESIGN: We correlated serial tracheal aspirates with radiographic findings from 183 infants whose birth weight was < or = 1250 gm. BPD severity was assessed by oxygen dependency at 36 weeks of postconceptional age (36 w PCA) and at the time of discharge. Two radiologists independently scored films taken at birth and 1, 7, 14, 21, 28, and 35 days of life. RESULTS: Of the study population, 55% were male and 35% were black; 80% received surfactant and 69% received dexamethasone; 91% survived. GPC isolates from throat cultures were mainly Staphylococcus [corrected] epidermidis and Streptococcus haemolyticus. A superimposed GNB colonization was present in 37% of these infants. Most common isolates were Klebsiella pneumoniae, Enterobacter cloacae, and Escherichia coli. Sepsis caused by GPC developed in 16% of all patients; 7% had sepsis caused by GNB. Infants infected with GNB remained receiving oxygen at 36 w PCA and at the time of discharge twice as often as those noninfected. RADIOLOGIC FINDINGS: Hyperinflation, interstitial changes, and generalized or localized emphysema were prominent features throughout. Mean radiologic scores increased over time in a pattern similar among GPC, GNB, and U. urealyticum infected and noninfected infants. High radiologic scores were not predictive at any time of infants who needed supplemental oxygen at 28 days and at 36 w PCA. Infants infected with U. urealyticum were neither clinically nor radiologically different than noncolonized neonates. CONCLUSION: GPC, GNB, and U. urealyticum airway colonization is not associated with particular radiographic changes at any time. GNB-infected infants had the most severe BPD course, and yet they were radiologically indistinguishable from the other patients. U. urealyticum colonization does not result in more clinically severe BPD or demonstrate a unique radiologic course.     

Radiation-induced temporary epilation after a neuroradiologically guided embolization procedure

A 34-year-old woman underwent embolization of a left paraorbital arteriovenous malformation guided with a bi-plane x-ray system in two sessions separated by 3 days. Imaging included 110 minutes of fluoroscopy and 46 digital subtraction angiography acquisitions. Entrance skin dose rates were determined with measurements performed on a skull phantom. The maximum possible skin dose was estimated to be 6.6 Gy, which is consistent with the temporary epilation in the right occipital region of the skull reported by the patient approximately 5 weeks later.     

The Society of Gastrointestinal Radiologists: its future and relevance

The authors present a case of tremor isolated to the lower extremity that was treated with stereotactically guided thalamotomy in a patient with Parkinson's disease. The technology that makes this procedure effective for this particular manifestation of parkinsonism is discussed.     

Escherichia coli associated cellulitis in broilers: correlation with systemic infection and microscopic visceral lesions, and evaluation for skin trimming

In Alberta, cellulitis condemnations average 0.5% and are among the highest in Canada. Presently, all cellulitis-affected birds are condemned for fear of systemic infections and public health implications. In a slaughterhouse sample of 102 birds condemned with cellulitis, Escherichia coli was isolated from 83.3% of the lesions. All hearts were cultured and from 11.2% E. coli was recovered. Gross lesions of perihepatitis, infected oviducts, and arthritis were found in 11.2%, 6.7%, and 2.9% of the birds, respectively. Serotyping suggested that visceral infection occurs independent of cellulitis in at least half of the cases. There was no correlation between microscopic visceral lesions and positive bacterial cultures. Two E. coli isolates of serogroup 0157 produced no toxin and neither isolate produced CS31A, F107, or F1845 fimbriae. Cellulitis lesions ranged from 0.55 to 218.9 cm2. All lesions under 16 cm2 and 64% of lesions up to 48 cm2 were considered suitable for trimming.     

Quantitative electroencephalographic characteristics of crack cocaine dependence

This study replicates preliminary findings reporting a quantitative electroencephalographic (QEEG) profile of crack cocaine dependence in abstinence. All subjects (n = 52) met criteria for DMS-III-R cocaine dependence (in the form of crack), and were residing in a drug-free therapeutic community. Baseline QEEG evaluations were conducted at intake (5-10 days after last use of crack, and at follow-up (1 month after last reported use). Previous findings of significant excess of relative alpha power and deficit of absolute and relative delta and theta power were replicated in this expanded group. Abnormalities were greater in anterior than posterior regions, and disturbances in interhemispheric relationships were also observed. Further, QEEG showed little change in the interval between the first and second evaluations. This QEEG profile may reflect persistent alterations in neurotransmission as a possible consequence of chronic cocaine exposure.     

The characterization of a subgenomic RNA and in vitro translation products of oat chlorotic stunt virus

Apoptosis has classically been viewed as a process not involving mitochondria, whereas the implication of mitochondrial dysfunction in necrosis has been recognized for several decades. Recently, it has become clear that apoptosis implies a disruption of mitochondrial membrane intregrity that is decisive for the cell death process. Cytofluorometric methods assessing the mitochondrial membrane function and structure can be employed to demonstrate that, at least in most models of apoptosis, mitochondrial changes precede caspase and nuclease activation. Moreover, pharmacological and genetic experiments suggest that the loss of mitochondrial membrane integrity is a critical event of the apoptotic process, beyond or at the point of no return of programmed cell death. Inhibitors of the mitochondrial megachannel (= permeability transition pore) can prevent both the mitochondrial and the post-mitochondrial manifestations of apoptosis.     

Effects of intravenous medium-chain triglycerides on pulmonary gas exchanges in mechanically ventilated patients

OBJECTIVE: In mechanically ventilated patients, pulmonary gas exchange was investigated during the administration of total parenteral nutrition containing medium-chain triglycerides or long-chain triglycerides as fat emulsions. DESIGN: Prospective, randomized, crossover trial (two lipid infusion periods of 8 hrs). SETTING: Intensive care unit in a university hospital. PATIENTS: Six mechanically ventilated patients, using the pressure-support mode. INTERVENTIONS: Total caloric intake was adapted according to measured energy expenditure. Fat emulsion provided 50% of the energy expenditure. Patients were infused with 50% medium-chain/50% long-chain triglycerides or 100% long-chain triglycerides in a random sequence. MEASUREMENTS AND MAIN RESULTS: Oxygen consumption, CO2 production, and minute ventilation were measured by indirect calorimetry. PaO2 and PaCO2 were determined in blood samples. Medium-chain triglycerides increased oxygen consumption by 27.8% and minute ventilation by 14.3% at the end of the protocol. CO2 production, PaO2, and PaCO2 were not different between groups. CONCLUSIONS: Medium-chain triglycerides cause an increase in metabolic demand in mechanically ventilated patients when they are infused over a short period. Postoperative or intensive care unit patients with a low pulmonary reserve should receive infusions of medium-chain triglycerides over a more prolonged period than long-chain triglycerides.