Cancer-specific genomic instability in bronchial lavage: a molecular tool for lung cancer detection.

We examined genomic instability in DNA from 80 bronchial lavage samples from patients with lung cancer and individuals with no malignant lung disease. We used a multiplex assay of eight fluorescent-tagged microsatellite markers that have a very high incidence of allelic imbalance in lung tumors. When genomic instability at individual loci was analyzed statistically against diagnosis, markers D3S1289 (P = 0.033), D3S1300 (P = 0.001), D13S171 (P = 0.009), and D17S2179E (P = 0.017) demonstrated significantly higher frequency of instability in bronchial lavage specimens from lung cancer cases than those with nonmalignant conditions. In contrast, markers D9S157, D9S161, D13S153, and D5S644 demonstrated lower specificity (P > 0.05) for lung tumors. These results suggest that genomic instability in some loci may be related to high proliferation rates but not necessarily to cell commitment to malignancy. When genomic instability was scored with only the four cancer-specific markers, the assay produced a sensitivity of 73.9% and a specificity of 76.5%. On combining the results from the cytological examination and the molecular assay, the sensitivity reached 82.6%. These results indicate that in our efforts to investigate genomic instability as a potential marker for the early detection of lung cancer, we need to identify cancer-specific genomic instability markers. This paper has shown that these first four markers may be considered to form an individual set of cancer-specific genomic instability markers.

Pulsatile ocular blood flow and intraocular pressure during retrobulbar injection of lignocaine: influence of additives.

PURPOSE: To assess the influence of adrenaline and hyaluronidase on pulsatile ocular blood flow and intraocular pressure changes during retrobulbar anesthesia. METHOD: Patients undergoing cataract surgery under local anesthesia received a 5-mL retrobulbar injection of lignocaine with either adrenaline, hyaluronidase, or no addition. Continuous pneumotonometry was performed using the OBF tonograph (OBF Labs, Chippenham, UK), which automatically derives pulsatile ocular blood flow values. Measurements were taken before and one minute after injection, and changes were compared between groups to evaluate the effects of changing the constituents of the injection. RESULTS: There was a marked decrease in pulsatile ocular blood flow during injection in all groups. In the group receiving lignocaine with hyaluronidase, the decrease in pulsatile ocular blood flow (mean -141 microL/min) was significantly less than in either the group receiving lignocaine and adrenaline (mean -249 microL/min) or the group receiving lignocaine alone (mean -245 microL/min). There was no significant change in intraocular pressure in any group. CONCLUSION: Hyaluronidase appears to lessen the reduction in pulsatile ocular blood flow. Injection volumes of 5 mL need not cause significant intraocular pressure change.

Pulsatile ocular blood flow measurements in healthy eyes: reproducibility and reference values.

PURPOSE: To determine the reproducibility and the normal reference range of pulsatile ocular blood flow (POBF) values in healthy subjects using the Ocular Blood Flow Tonograph (OBF Laboratories, UK Ltd., Wiltshire, England). METHOD: Pulsatile ocular blood flow was measured in one eye of each of 83 patients. Coefficient of reliability was determined by calculation of intraclass correlation coefficient via one-way analysis of variance. Mean difference between measurements was calculated for bias and first exposure effects. Pulsatile ocular blood flow from 163 healthy individuals were analyzed to determine the distribution, mean, standard deviation (SD), range, and the 5th and 95th percentile values. The influence of age, blood pressure, pulse rate, and intraocular pressure on pulsatile ocular blood flow was determined by regression analysis. RESULTS: Reliability coefficient for pulsatile ocular blood flow values ranging from 290 microliters/min to 2,196 microliters/min was 0.92. Variation in bias and first exposure effect were not significant. Pulsatile ocular blood flow values were normally distributed. Mean values were 669.90 +/- 233.0 microliters/min in men and 841.90 +/- 254.6 microliters/min in women. Fifth and ninety-fifth percentile values were 364.75 microliters/min and 1,266.10 microliters/min in men and 397.18 microliters/min and 1,346.10 microliters/min in women. Pulsatile ocular blood flow was significantly influenced by pulse rate. CONCLUSION: This study confirms the reliability of the Ocular Blood Flow Tonograph in repeated measurements of POBF within individuals over short time intervals. The high interindividual variation in POBF may invalidate comparison of POBF between individuals, and the wide range of normal values may limit the value of using a low POBF as a possible indicator of disease.

Passing the DVLC field regulations following bilateral pan-retinal photocoagulation in diabetics.

Twenty-one diabetics who had had bilateral retinal panphotocoagulation preserving a visual acuity sufficient to pass the Driver and Vehicle Licensing Centre (DVLC) requirements were assessed with regard to their ability to satisfy the DVLC visual field requirements. Of the 19 patients treated with the laser alone, 17 met the requirements for a licence to drive a private vehicle. The use of the Xenon photocoagulator and large total burn area following laser was found to be associated with an increased risk of DVLC field test failure. Adequate PRP with 200 micron burns appeared to induce neovascular regression and be compatible with passing the DVLC field regulations in many patients. Panphotocoagulation of patients with early proliferative retinopathy using 200 micron burns does not appear to jeopardise a driving licence. Guidelines for laser treatment in diabetic retinopathy aimed at preserving the driving field are presented.

A study of the eye care provided by an accident and emergency department.

The eye care provided by an Accident and Emergency (A&E) Department was prospectively studied over a 2-month period. Six out of a total of 506 patients were deemed to have been treated unsatisfactorily by the A&E Department. None of these patients suffered serious sequelae. Approximately one in three of those patients seen solely by A&E staff failed to have their visual acuity recorded.

Efficacy of eyepad in corneal healing after corneal foreign body removal.

30 patients with corneal epithelial defect due to removal of corneal foreign bodies were randomly allocated to receive either chloramphenicol with continuous application of an eyepad or chloramphenicol without the eyepad. Almost all corneal defects were healed at 24 h, and all were healed by 48 h, with no statistically significant difference between the two groups. Discomfort at 24 h was greater in the eyepad group than in the control group. An eyepad seems to confer no benefit in healing and is uncomfortable.

Effect of age and menopausal status on estimates of oestrogen binding by human malignant breast tumours.

The uptake of oestradiol by human breast-tumour tissue estimated by in-vivo and in-vitro techniques has been examined in relation to patients' ages and menopausal status. Results from in-vivo studies showed no convincing correlations, while in-vitro results were significantly correlated with menopausal status. There was a significant correlation between results obtained by the two techniques.