ABSTRACT
The term anal squamous intraepithelial lesion (ASIL) is used to describe premalignant change of anal squamous cells that precede the development of squamous cell carcinoma. Pathophysiology is driven by the human papilloma virus (HPV), and progression and regression of ASIL being well described, with 12% of high-grade lesions progressing to invasive cancer within 5 years. Vaccination against HPV is effective for primary prevention. Management consists of identification and treatment of high-grade lesions to prevent progression to squamous cell carcinoma. Management of established ASIL aims to avoid the progression to invasive cancer and maintain fecal continence. A combination of surveillance, excision, ablative, or topical therapies is used to achieve this. The aim of the present study was to review the contemporary evidence about ASIL and to suggest a management algorithm.
Subject(s)
Anus Neoplasms , Carcinoma in Situ , Papillomavirus Infections , Squamous Intraepithelial Lesions , Algorithms , Anus Neoplasms/diagnosis , Anus Neoplasms/therapy , Anus Neoplasms/virology , Humans , Papillomaviridae , Squamous Intraepithelial Lesions/diagnosis , Squamous Intraepithelial Lesions/therapy , Squamous Intraepithelial Lesions/virologyABSTRACT
BACKGROUND: The incidence of obesity is increasing in New Zealand. The aim of the study was to determine whether obesity impacts on the cost of treating patients undergoing major colorectal surgery. METHODS: Between 1 February 2008 and 31 July 2009, consecutive patients undergoing major colorectal surgery at Christchurch Hospital, New Zealand, were enrolled in the study. Body mass index (BMI) and waist-to-hip ratios were assessed using standardized techniques. Patients with a high surgical risk were identified using established criteria and all patients were assessed using the Portsmouth modification of the Physiological and Operative Severity Score for the enUmeration of Mortality and morbidity (P-POSSUM). Cost analysis was performed using a structured query language database. Patients were analysed using accepted groupings for BMI, waist circumference and waist-to-hip ratio. RESULTS: A total of 372 patients were enrolled in the study, of whom 345 were included in the analysis. The incidence of diabetes was significantly higher with increased BMI (P = 0·002), whereas all other co-morbidities, and P-POSSUM values, did not differ between BMI groups. The groups were similar in terms of case mix. Treatment of obese patients (BMI at least 30 kg/m(2)) was significantly more expensive than that of normal weight patients (BMI 20-24·9 kg/m(2)): 10,036 versus 7390 (P = 0·005). Treatment costs for patients with a BMI of 25-29·9 kg/m(2) were next highest (9048) followed by those for patients whose BMI was less than 20 kg/m(2) (8884). Patients with a waist circumference above recognized standards for men and women also cost significantly more to treat (10,063 versus 7836; P = 0·014). CONCLUSION: Excess body fat was associated with higher costs of major colorectal surgery.
Subject(s)
Colorectal Surgery/economics , Obesity/complications , Adolescent , Adult , Aged , Aged, 80 and over , Body Mass Index , Costs and Cost Analysis , Diabetes Complications/economics , Female , Humans , Laparoscopy/economics , Male , Middle Aged , New Zealand , Obesity/economics , Risk Factors , Waist-Hip Ratio , Young AdultABSTRACT
The mechanism of action of Sterilox, a non-toxic liquid biocide produced by electrolysis of a dilute saline solution, upon planktonic cells of Escherichia coli JM109 was investigated using protein and nucleic acid analysis. The results revealed total destruction of chromosomal and plasmid DNA, RNA and proteins of E. coli within 5 min of exposure. Our earlier investigation conducted using atomic force microscopy imaging revealed swelling and rupture of E. coli cells with release of cytoplasm. We propose that the biocidal properties of Sterilox are due to its effect upon constituents of the bacterial cell including proteins and nucleic acids.
Subject(s)
Disinfectants , Escherichia coli/drug effects , Hydrogen Peroxide , Oxidants , Bacterial Proteins/drug effects , DNA Damage/drug effects , DNA, Bacterial/drug effects , Drug Evaluation, Preclinical , Electrophoresis, Polyacrylamide Gel , Escherichia coli/classification , Escherichia coli/genetics , Humans , Microscopy, Atomic Force , Oxidation-Reduction , Plasmids/drug effects , RNA, Bacterial/drug effects , SerotypingABSTRACT
Time-of-flight secondary ionisation mass spectrometry and X-ray photoelectron spectroscopy were employed to determine the interaction of crude extracellular polymeric substances recovered from static batch cultures of two isolates of marine sulphate-reducing bacteria of the genus Desulfovibrio, grown in the presence of and without mild steel surfaces, with Fe ions released from steel. The results demonstrated that exopolymers synthesised by different strains of sulphate-reducers varied in their ability to bind iron originating from steel. Based on the X-ray photoelectron spectroscopy analysis it is proposed that Fe released from steel was associated with bacterial exopolymers such as Fe(III) ion. The application of surface science techniques to study exopolymer/metal interaction allowed quantitative evaluation of Fe binding using small sample size.
Subject(s)
Desulfovibrio/metabolism , Electron Probe Microanalysis , Iron/metabolism , Polymers/metabolism , Spectrometry, Mass, Secondary Ion/methods , Culture Media , Steel , Sulfur/metabolismABSTRACT
A combination of scanning electron microscopy (SEM) and environmental scanning electron microscopy (ESEM) techniques, as well as atomic force microscopy (AFM) methods has been used to study fragments of the Martian meteorite ALH84001. Images of the same areas on the meteorite were obtained prior to and following gold/palladium coating by mapping the surface of the fragment using ESEM coupled with energy-dispersive X-ray analysis. Viewing of the fragments demonstrated the presence of structures, previously described as nanofossils by McKay et al. (Search for past life on Mars--possible relic biogenic activity in martian meteorite ALH84001. Science, 1996, pp. 924-930) of NASA who used SEM imaging of gold-coated meteorite samples. Careful imaging of the fragments revealed that the observed structures were not an artefact introduced by the coating procedure.
Subject(s)
Carbonates/analysis , Exobiology/methods , Mars , Meteoroids , Extraterrestrial Environment , Fossils , Geology/methods , Microscopy, Atomic Force , Microscopy, Electron, Scanning , Paleontology/methods , Particle SizeABSTRACT
Micturating renograms often need to be carried out on children, with whom difficulty may be experienced in synchronizing onset of micturition with camera and computer acquisition. A flow detection system has been developed which will automate these acquisitions, resulting in far fewer false starts or lost studies. The unit was developed specifically for the camera/computer system in our department (IGE 400T and DEC 11/34) but with only minor modifications would be suitable for interfacing to other equipment. It is a free standing unit which requires no modifications of the camera or computer circuitry apart from access to the remote start buttons.
