Cluster of allele losses within a 2.5 cM region of chromosome 10 in high-grade invasive bladder cancer.

A limited number of previous studies have indicated a low frequency of chromosome 10 allele losses and deletions in bladder cancers. We investigated the involvement of chromosome 10 in advanced bladder cancers. Loss of heterozygosity (LOH) was analysed in 19 microsatellite loci in 20 grade III invasive transitional cell carcinomas. Nine (45%) of the 20 tumors had at least one allele loss on the long arm of chromosome 10. The short arm of chromosome 10 was not affected. The most frequent LOH occurred at D10S215, where four (29%) of 14 of the informative cases had an allele loss. The minimal region with allele losses was located between the centromeric marker D10S1644 and the telomeric marker D10S541, which are separated by 2.52 cM. The results strongly suggest the existence within that region of a tumor suppressor gene or genes for advanced bladder cancer.

Subtotal calcanectomy for chronic heel ulceration.

Subtotal or partial calcanectomy is a well-documented procedure. Its application in both ambulatory and nonambulatory patients with chronic heel ulceration is proposed as a desirable alternative to amputation. The authors expand on the candidate spectrum and discuss history, indications, criteria, technique, and postoperative course in different patient populations.

The pulsed holmium: yttrium-aluminum-garnet laser. Applications to ankle arthroscopy.

The holmium:YAG laser has many advantages over conventional surgical instrumentation and techniques in ankle arthroscopy. These include minimal mechanical damage to surrounding tissue structures, better access to tight recesses, and the ability to coagulate, smooth, ablate, and weld tissues. The laser also offers improved contouring of damaged articular surfaces, all with a single instrument. The holmium:YAG laser uses a wavelength of 2.1 microns, which is strongly absorbed by water, the major component of tissue. This wavelength allows the laser to deliver a consistent tissue effect to both pigmented and nonpigmented tissues. It currently may transmit up to 60 watts of power to tissue in high-energy, short-duration pulses. The holmium:YAG laser also operates in a fluid medium, which provides a near physiologic environment and maintains continual irrigation. The holmium:YAG laser beam is transmitted through a flexible fiberoptic handpiece, which greatly increases maneuverability. A variety of angled laser tips are available, depending on the pathology type and location. Different tissue effects can be created by varying the tip to target distance. All these qualities provide precise control without significant thermal damage and make the laser ideal for application to articular structures of the ankle joint. The holmium:YAG laser is a safe and effective arthroscopic instrument with a promising future. We have used it, along with traditional shavers and abraders, to effectively treat numerous pathologies of the ankle joint. The laser's versatility in cutting, ablation, and coagulation has been uniformly successful. Patients surveyed postoperatively have reported less overall symptoms and faster healing. They have reported a decrease in ecchymosis, edema, and postoperative pain. Patients' return to full activity has appeared to be quicker with the use of holmium:YAG laser therapy. Although our results have thus far been very encouraging, further research and clinical applications in the use of the holmium:YAG laser need to be continued.

Postural alignment in barefoot and high-heeled stance.

The posture of nineteen subjects under two conditions of footwear was analyzed for differences in the location of the line of gravity of the body with respect to anatomical landmarks. Intrasubject comparison of barefoot and high-heeled stance showed that the wearing of high heels caused lumbar flattening, a backward tilting pelvis, a reduction of the distance of the knee and ankle from the line of gravity, and a posterior displacement of the head and thoracic spine. The alignment at the greater trochanter did not vary with heel height, perhaps indicating a need to maintain a constant extending moment loading at the hip joint. The change in lumbar lordosis measured in high-heeled stance is inconsistent with clinical findings of hyperlordosis in habitual wearers of high-heeled shoes. It is possible, however, that changes in postural muscle tone due to the altered pelvic inclination may, in the long term, result in hyperlordosis of the lumbar spine.