Linkage disequilibrium and haplotypes of five TP53 polymorphisms in oesophageal cancer patients

The aim of present study was to evaluate the linkage disequilibrium (LD) of p.R72P, PIN3 Ins16bp, p.P47S, p.R213R and r.13494g[a polymorphism of TP53 and their haplotypes association with oesophageal cancer risk in patients from Punjab, northwest India. A total of 466 samples, including 233 oesophageal cancer patients and 233 healthy individuals were analysed. Data analysis revealed the gender specific association. In female group, arginine–proline (RP) genotype (P = 0.08) and P allele (P = 0.07) of p.R72P polymorphism was marginally associated with increased risk of oesophageal cancer. A1A2 genotype (P = 0.06) and A2 allele (P = 0.07) of PIN3 Ins16bp polymorphism was marginally associated with decreased risk of oesophageal cancer in male group. A1A2–GA genotype combination (P = 0.04) of PIN3 and r.13494g[a polymorphisms was significantly associated with decreased risk of oesophageal cancer in male group. In female group, PP–GA genotype combination (P = 0.02) of p.R72P and r.13494g[a polymorphisms and RP–A1A1–GG genotype combination (P = 0.04) of p.R72P, PIN3 and r.13494g[a polymorphisms was significantly associated with increased risk of oesophageal cancer. We observed moderate LD between two intronic polymorphisms PIN3 Ins16bp and r.13494g[a (D0 = 0.90; r 2 = 0.68). Haplotype analysis revealed that none of the haplotype combination was associated with oesophageal cancer risk when both the genders were considered. Stratification on the basis of gender showed that P-A2-P-A-A haplotype of p.R72P, PIN3 Ins16bp, p.P47S, p.R213R and r.13494g[a polymorphisms was marginally associated with reduced oesophageal cancer risk in male group (P = 0.08). Replication of these findings in independent cohorts may be insightful for the role of TP53 in oesophageal cancer pathogenesis.

Laparoscopic cholecystectomy in a patient with pneumonectomy

Post pneumonectomy patients pose a challenge to the anaesthetist owing to the altered respiratory mechanics and decreased respiratory reserve. Performing laparoscopic surgery in such patients further deteriorates the already compromised lung functions. Authors report a case of laparoscopic cholecystectomy performed in post pneumonectomy patient. A clear understanding of respiratory mechanics and post pneumonectomy physiological changes helped us to administer a safe anaesthesia and safe perioperative outcome.

Malignant germ cell tumour in an infant vagina

@#The mother of a 9-month-old female infant complained that her child was unable to pass urine at the same time noticing a mass protruding from the vaginal orifice.The infant had a single episode of vaginal bleeding.The primary concern of the mother was the inability of the daughter to micturate. Malignant germ cell tumour arising from an infant vagina is rare and accounts for about 3% of all paedriatic malignancies. These are also referred to as endodermal sinus tumours or yolk sac tumours, and are mostly the commonest form of infant vaginal malignancies encountered. A diagnosis of endodermal sinus tumour was established based on the histology and raised α-fetoprotein levels.These tumours had Schiller-Duval bodies which are primarily blood vessels surrounded by primordial germ cells and were periodic acid shift (PAS) positive diastase resistant hyaline globules which also stain positive with αfetoprotein which is an important diagnostic feature. Tumours with high α-fetoprotein levels have a poorer prognosis. However, they respond satisfactorily to chemotherapy

Buttonhole Cholecystectomy: Modified Approach – A Prospective Study of Twenty Five Cases

Cholelithiasis is a common disorder affecting large number of population in the world.open cholecystectomy has been the treatment of choice for symptoms of gall stones for many years. . Another less explored type of cholecystectomy is button hole cholecystectomy which is performed through a single incision of 2.5 cm in length. This study aimed at evaluating cholecystectomy through a button hole incision and its efficacy and decrease in post operative morbidity. Methods: Twenty five patients reporting on two specific days of a week with cholelithiasis, treated and followed up at Guru Nanak Dev hospital Punjab were included in the study. Results: The study was conducted on 25 patients consisting of 19 females and 6 males. The most common symptom was right hypochondrial pain followed by vague dyspepsia. Fever was present in 3 patients. Conclusion: Buttonhole cholecystectomy is a safe and easily performed procedure which does not require any sophisticated equipment. It is a patient friendly procedure and does not require the elaborate layout of laparoscopic cholecystectomy. It is also less costly and requires no special training.

Re-definition of position and calculation of safe area for axillary nerve in deltoid muscle with its clinical relevance: a cadaveric study / 대한해부학회지

Several authors have made efforts to define the position of the axillary nerve within deltoid muscle and to calculate the so called safe area for this nerve but it still remains a matter of debate. The primary aim of the study was to investigate the acromio-axillary (AA) distance and its correlation with upper arm length. The secondary aim was to re-define the safe area for axillary nerve within deltoid muscle. Sixty shoulders of thirty adult human cadavers were dissected using standard methods. The distance from the anterior and posterior edge of acromion to the upper border of the course of the axillary nerve was measured and recorded as anterior and posterior AA distance respectively. Correlation analysis was done between the upper arm length and AA distance for each limb. The ratios between anterior and posterior AA distance and upper arm length were calculated and mentioned as anterior index and posterior index, respectively. The mean of anterior and posterior AA distance was 5.22 cm and 4.17 cm, respectively. The mean of upper arm length was 29.30 cm. The means of anterior index and posterior indices were 0.18 and 0.14, respectively. There was a significant correlation between upper arm length and both the anterior and posterior AA distance. The axillary nerve was found to lie at variable distance from the acromion. The minimum AA distance was found to be 3.50 cm. So this should be considered as the maximum permissible length of the deltoid split. Upper arm length has strong correlation with both anterior and posterior AA distances. The ideal safe area for the axillary nerve was found to be a quadrangular area above it and the size of which depends on the length of the upper arm.

Penile Paraffinoma

Penile augmentation with injection of paraffin is a common practice in South East Asia. Penile paraffinoma occurring due to injection of liquid paraffin to enhance the size of the penis is an uncommon condition. Normally, this procedure is carried out by nonmedical personnel, without the prior knowledge or consultation of any urologist. The occurrence of such a deforming procedure is not commonly known to the medical profession in Malaysia.

Primary germ cell tumor of the mediastinum

Germ cell tumors compromise 15-20% of all anterior mediastinal masses; 50-60% of these are benign mediastinal teratoma. There may be mature, immature, and rarely with malignant component within the tumor mass. There are more chances of malignancy with immature type. We are reporting a case in 20-year young male diagnosed as giant benign cystic teratoma which was adherent to superior vena cava. The patient underwent surgical excision. In follow up of 2 years, the patient is not having any complaints

Rectal schwannoma.

Solitary schwannomas constitute only 2%-6% of stromal tumors of the gastrointestinal tract; the stomach is the preferred site of involvement. We report a 35-year-old woman who presented with difficulty in defecation. A mass on the posterior wall of the rectum was excised. Histologically, the lesion was a schwannoma, with S-100 proteins positivity and glial fibrillary acidic protein immunoreactivity. The patient is asymptomatic two years later.