Telomerase activity in transthoracic fine needle biopsy aspirates as a marker of peripheral lung cancer.

BACKGROUND: A study was undertaken to evaluate the usefulness of telomerase activity assay in transthoracic fine needle biopsy (TFNB) aspirates collected from peripheral tumours of the lung in predicting the malignant aetiology of lung infiltrations. METHODS: 100 patients with a peripheral infiltration of the lung underwent TFNB of the focal lesion. The aspirates were subjected to standard cytological evaluation. Telomerase activity in the specimens was determined with the PCR-ELISA PLUS method. The sensitivity, specificity, accuracy and predictive value of TFNB were calculated for cytological examination of aspirates alone and cytological examination with additional telomerase activity assessment. RESULTS: Lung cancer was newly diagnosed in 84 subjects and benign peripheral lesions were found in 16. During the first TFNB, lung cancer was identified in 56 cases of cancer (66.7%) while increased telomerase activity was found in 61 cancer aspirates (72.6%). No subject with a benign infiltration had a false positive result from cytological examination, but in one case (6.25%) increased telomerase activity was observed. The diagnostic sensitivity, accuracy and negative predictive value of the combination of cytological examination and telomerase activity assay in TFNB specimens were significantly higher than for cytological examination alone (89.3% vs 66.7%, p = 0.0004; 90% vs 72%, p = 0.001; 62.5% vs 36.4%, p = 0.039), but a combination of the two examinations was associated with a lower specificity of TFNB (96.9% vs 100%, p = 0.002). CONCLUSION: Detection of telomerase activity in aspirates taken during TFNB of a peripheral lung infiltration should be considered as an indication of the risk of malignancy in cases with false negative cytological results.

Is mechanical bowel preparation really necessary for elective left sided colon and rectal surgery?

The value of mechanical bowel preparation for elective left sided colorectal surgery is debatable. This retrospective study evaluates the incidence of wound infection, wound dehiscence, abdominal/pelvic collections and anastomotic dehiscence between patients who received mechanical bowel preparation [MBP] (n = 61) and those who did not (n = 75). The case notes of 136 consecutive patients undergoing elective left sided colorectal surgery over a three year period in a district general hospital were reviewed. The incidence of infective and anastomotic complications between the two groups was not significantly different. There were two post-operative deaths, both in patients receiving MBP. We therefore conclude that the role of MBP in the era of systemic antibiotics must be questioned. A prospective randomised multicenter trial recruiting an adequate number of patients undergoing elective left sided colorectal procedures would clarify this long standing debate. Note: Presented at the Spring Meeting of the Minnesota Surgical Society in Rochester, Minnesota, USA, May, 1996 and to the American Society of Colon and Rectal Surgeons (ASCRS), Seattle, Washington, June 1996, and published in abstract form in Diseases of the Colon and Rectum (1996) 39:A47.

[Analysis of ventilation parameters before and after fiber optic bronchoscopy in patients with atopic bronchial asthma and chronic obstructive pulmonary diseases]. / Analiza wskazników wentylacyjnych przed i po badaniu bronchofibroskopowym u chorych na astme oskrzelowa i przewlekla obturacyjna chorobe pluc.

Bronchial asthma and chronic bronchitis in a stable period of the disease could be an indication for diagnostic bronchofiberoscopy. The aim of the authors of this article is to assess whether bronchoscopy may be safely used either as diagnostic or therapeutic procedure. 21 patients (age 33-46), 13 with atopic bronchial asthma and 8 with COPD took part in this study. The measurements were carried out one day before and 3 hours after the bronchoscopy. The following parameters: Forced Vital Capacity (FVC), Forced Expiratory Volume (FEV1), Forced Expiratory Flow (FEF25, FEF50, FEF75) and Resistance of Airways (R aw) were taken into consideration. It was shown that bronchofiberoscopy could be performed safely in these patients and did not lead to woersing ventilation parameters. Bronchospasm was not observed during the study. Moreover the increase in FEF50, FEF75 and R aw were observed. This significant decrease of amount of bronchial discharge could serve as an explanation of this phenomenon.