Clinical correlations of extraocular motility limitation pattern in orbital fracture cases: a retrospective cohort study in a level 1 trauma centre.

PURPOSE: Ocular pathology (OP) following orbital fracture can vary vastly in complexity and severity. Extra-ocular motility (EOM) limitations are frequently present in orbital trauma cases, with patterns of duction limitations being symmetrical or asymmetrical. The aim of this study was to identify if there was any association between increased OP following orbital fracture cases based on the pattern of EOM deficits. METHODS: This is a retrospective cohort study of patients with fractured orbits presenting with or without EOM limitations to a level 1 trauma center between August 2015 to January 2018. All pertinent elements of the ophthalmic examination were recorded. Outcome measures: Chi-square analyses assessed for association between symmetrical or asymmetrical EOM limitation and OP. Odds ratios were calculated with 95% confidence interval. RESULTS: 278 orbits with wall fractures were included in this study. A significant correlation between EOM limitation and increased OP following orbital trauma was found (p = 0.000081). Cases with symmetrical and asymmetrical EOM limitation were 7.9 (95%CI: 2.3-27.2) and 5.22 (95%CI: 1.9-13.9) times more likely to have OP than cases with no EOM limitation, respectively. With extraocular muscle entrapment excluded, cases with symmetrical limitations had a significantly higher incidence of OP than cases with asymmetrical limitations (p = 0.0161). CONCLUSIONS: OP is frequently observed in cases of orbital fracture. While any EOM limitations should prompt the clinicians to anticipate OP, intra-ocular injury may be more likely in cases of symmetrical EOM limitation. Future prospective studies are needed to further elucidate the relationship between EOM symmetricity and OP following orbital trauma.

The radiology workforce's response to the COVID-19 pandemic in the Middle East, North Africa and India.

INTRODUCTION: This study aimed to investigate the response of the radiology workforce to the impact of the coronavirus disease 2019 (COVID-19) pandemic on professional practice in India and eight other Middle Eastern and North African countries. It further investigated the levels of fear and anxiety among this workforce during the pandemic. METHODS: A quantitative cross-sectional study was conducted using an online survey from 22 May-2 June 2020 among radiology workers employed during the COVID-19 pandemic. The survey collected information related to the following themes: (1) demographic characteristics, (2) the impact of COVID-19 on radiology practice, and (3) fear and (4) anxiety emanating from the global pandemic. RESULTS: We received 903 responses. Fifty-eight percent had completed training on infection control required for handling COVID-19 patients. A large proportion (79.5%) of the respondents strongly agreed or agreed that personal protective equipment (PPE) was adequately available at work during the pandemic. The respondents reported experiences of work-related stress (42.9%), high COVID-19 fear score (83.3%) and anxiety (10%) during the study period. CONCLUSION: There was a perceived workload increase in general x-ray and Computed Tomography imaging procedures because they were the key modalities for the initial and follow-up investigations of COVID-19. However, there was adequate availability of PPE during the study period. Most radiology workers were afraid of being infected with the virus. Fear was predominant among workers younger than 30 years of age and also in temporary staff. Anxiety occurred completely independent of gender, age, experience, country, place of work, and work status. IMPLICATIONS FOR PRACTICE: It is important to provide training and regular mental health support and evaluations for healthcare professionals, including radiology workers, during similar future pandemics.

RISK FACTORS AND SERO-PREVALENCE OF HEPATITIS B SURFACE ANTIGEN AMONG BLOOD DONORS IN UNIVERSITY OF ILORIN TEACHING HOSPITAL, ILORIN, NIGERIA.

BACKGROUND: Availability of safe blood and blood products for transfusion is increasingly difficult globally, especially in developing countries because of high prevalence of Transfusion Transmissible Infections. OBJECTIVES: To determine the prevalence of HBsAg among blood donors and to evaluate the socio-economic, demographic and medical factors associated with its infection. DESIGN: A prospective study. SUBJECTS: Three hundred and fifty consecutive blood donors were recruited. 2 ml of venous blood was collected aseptically from the ante-cubital vein and subjected to serological test for HBsAg. RESULTS: High prevalence rate 10.9% was recorded. All the donors reactive to HBsAg were males (38,100%) with a mean age of 30.7 ± 8.02 years, while 55.3%, 44.7%, 5.3%, 42%, 47.4%, 5.3% of them were single, married, primary school graduate, secondary school graduate, tertiary school graduate and illiterate respectively with 36.8%, 23.7%, 39.5% and 0% been unemployed, civil servants/professionals, skilled artisans and business/petty traders. The most common risk factor was multiple sexual partners 55.3%, followed by extra marital affairs 13.2%, tattooing 10.5%, previous blood transfusion 5.2%, previous surgery 2.6% and sex trading 2.6%. CONCLUSION: Active public enlightenment programmes and strict blood donation selection criteria need to be put in place in order to provide safe blood and blood products for transfusion.

Sero-prevalence of syphilis among patients with mental illness: comparison with blood donors.

BACKGROUND: Mentally ill individuals (MII) are at risk of acquiring syphilis and other sexually transmitted infections. This study aimed at determining sero-prevalence of syphilis among MII and compare them with voluntary blood donors (VBD) at University of Ilorin Teaching Hospital (UITH), Nigeria. METHODS: A cross-sectional study done between June, 2010 and June 2011, and involving 350 each of VBDs and MII in and out-patients of UITH. Serological test was done using venereal disease research laboratory (VDRL) and the Treponema Pallidum Haemagglutination (TPHA) kit. RESULTS: Of the 700 subjects, 324 (92.6%) MII, and 349 (99.7%) VBDs were <55 years; 71 (21.4%) MII were Civil Servants compared with 96 (27.4%) VBDs. Significantly more VBDs had higher education than MII (185 or 52.9%, and 140 or 40% respectively). Christians constituted the majority (176 or 50.3%) among MII, and Muslims (210 or 60%) among VBDs. Significantly more married VBDs (204/206 or 99.0%) live with spouses; more VBDs consumed alcohol (37 or 10.6%), smoked (19 or 5.4%), and engaged in extramarital sex (105 or 30.0%). Significantly more MII had blood transfusion (40 or 11.4); engaged in sex trade (12 or 3.4%); and more syphilis prevalence (5.4%). In addition, more syphilitic MII smoked (18 or 94.7%); and all syphilitic MII had psychotic disorders. CONCLUSION: The prevalence of syphilis in MII is significantly higher than among VBDs. Routine screening of MII is advocated to stem this problem.

Population-based prevalence of hepatitis B and C virus, HIV, syphilis, gonorrhoea and chlamydia in male injection drug users in Lagos, Nigeria.

There is little research on injecting drug use in Nigeria. We investigated the prevalence of HIV, hepatitis B and C, and sexually transmitted infections (STIs) among male injection drug users (IDUs) in Lagos. Male IDUs (N = 328) were recruited through respondent-driven sampling. Participants completed an interview about their sexual and injecting risk behaviours and were tested for hepatitis B surface antigen (HBV), hepatitis C antibody (HCV), HIV and syphilis, as well as genital chlamydia and gonorrhoea infections. Three-quarters of IDUs (74%) reported injecting drugs in the past one month although most did not share needles (92%) and the majority obtained sterile needles from pharmacists (87%). Estimated HBV, HCV, HIV, syphilis, gonorrhoea and chlamydia prevalences were 7.8%, 7.7%, 0.9%, 1.9%, 0.0%, and 3.7%, respectively. The burden of HIV is presently low among IDUs in Lagos. Changes in accessibility to sterile needles at pharmacists would likely have a deleterious effect on IDUs' health. HBV vaccination and HCV prevention programmes for IDUs are urgently needed.

The correlates of stress, coping styles and psychiatric morbidity in the first year of medical education at a Nigerian University.

OBJECTIVES: This study was prompted by the heightened concerns about the stress inherent in medical education evident from the incessant requests for suspension of studies due to psychological problems. The objectives of the study were to: (i) survey the students for possible psychological problems at admission, and follow them up till exit for possible changes in morbidity, and (ii) ascertain possible risk factors, and coping strategies. METHOD: This is a preliminary 2-stage cross-sectional report, which is part of a longitudinal survey. It involves first year medical students of the College of Health Sciences of University of Ilorin between March and April, 2011. Questionnaires used included socio demographic, sources of stress, the general health questionnaire-12 (GHQ-12), Maslach's burnout inventory (MBI), and Brief COPE. Data were analysed using SPSS version 15 at 5% significance level. Chi-square, frequency distributions, Pearson's correlation, Odd ratios, and Confidence Intervals were calculated to determine the levels of risk. RESULTS: 79 students returned completed questionnaires. 12 (15.2%) were ghq-12 cases (i.e., scored ≥ 3). Students who had morbidity were 9 times at risk of being stressed consequent upon 'competing with their peers' and 4 times at risk due to 'inadequate learning materials'. Morbidity was significantly more likely to engender use of 'religion', 4 times less likely to engender use of 'positive reframing' with a trend in the use of 'self blame' as coping strategies. CONCLUSION: Aside from psychosocial/personal issues in this cohort, academic demand was an additional source of psychological problems thereby causing those who had morbidity to utilize 'religion' and 'positive reframing' to cope. There is therefore an apparent need to incorporate the principle of mental health promotion in medical education.

Hazardous alcohol use among doctors in a Nigerian tertiary hospital.

BACKGROUND: There has been conflicting reports of the level of hazardous alcohol use among doctors despite the significant occurrences in the general population. Hence, the need to study the drinking habits of doctors, being supposedly role models in terms of behavior and lifestyle. METHODS: All the consenting doctors in the employ of University of Ilorin Teaching Hospital, Nigeria completed questionnaires detailing the socio-demographic (e.g., age, gender, marital status, professional qualifications), work-related (e.g., leisure, workload, job satisfaction), and clinical (e.g., prior treatment) variables. The participants also completed the 10-items Alcohol Use Disorders Identification Test (AUDIT) and the General Health Questionnaire-12 (GHQ-12). RESULTS: Of the 241 participants, 'lifetime abstainers' constituted 173 (71.8%) while 'lifetime (ever) alcohol use' was 68 (28.2%), 'past (time specified abstainers) alcohol use' was 29 (12.0%), and 'current users' were 39 (16.2%). Ten (4.1%) participants were 'hazardous users' while 29 (12.0%) were 'moderate users'. Of the 'hazardous users', 3 (30.0%) were interns, 5 (50.0%) were residents while 2 (20.0%) were consultants. They were found in five departments: Obstetrics & Gynaecology, 4 (40.0%); Laboratory Medicine, 3 (30.0%); and 1 (10.0%) each in Pediatrics, Surgery, and Internal Medicine. Heavy workload was significantly related to being a 'hazardous drinker' (x² = 5.92, p= 0.015) while 'abstinence' within the previous 6 months was related to GHQ-12 caseness (i.e., morbidity) (x² =11.78, p= 0.0006). CONCLUSION: There was a detectable level of hazardous drinking especially amongst the junior doctors. Efforts should be focused on younger doctors and their workload.

Visceral hypersensitivity in endometriosis: a new target for treatment?

OBJECTIVE: In women presenting to gynaecological clinics with lower abdominal pain, the cause is frequently attributed to endometriosis irrespective of whether it is found to be minimal or extensive at laparoscopy. Irritable bowel syndrome (IBS) is also common in this setting, and it was speculated that the visceral hypersensitivity associated with this condition might be amplifying the symptoms of endometriosis. METHODS: Visceral sensitivity to balloon distension, symptoms and psychological status were assessed following laparoscopy in 20 women with minimal to mild endometriosis, 20 with moderate to severe endometriosis, 20 with laparoscopy negative abdominal pain and 20 asymptomatic women undergoing laparoscopic sterilisation who acted as controls, and compared with 20 women with IBS. RESULTS: Compared with controls, patients with minimal to mild and moderate to severe endometriosis had a higher prevalence of symptoms consistent with IBS (0% vs 65% and 50%, respectively, p<0.001) with significantly lower mean pain thresholds (39.5 mm Hg (95% CI 36.0 to 43.0) vs 28.1 mm Hg (95% CI 24.5 to 31.6), p=0.001 and 28.8 mm Hg (95% CI 24.9 to 32.6), p=0.002) not explained by differences in rectal compliance. Patients with laparoscopy negative pain had symptoms and visceral sensitivity similar to patients with IBS. Controls undergoing laparoscopy had normal sensitivity, indicating that the laparoscopic procedure was not inducing hypersensitivity. CONCLUSION: Visceral hypersensitivity is extremely common in endometriosis and could be intensifying the pain. This finding might explain why mildly affected individuals often complain of severe symptoms out of proportion to the extent of their disease. This study has introduced a completely new concept into the understanding of pain in endometriosis and could open up new opportunities for treatment.

Abdominal bloating and distension: what is the role of the microbiota.

Most patients with irritable bowel syndrome complain of a sensation of an increase in pressure within their abdomen during the course of the day which is called bloating and, in approximately half of these individuals, this symptom is accompanied by an actual increase in abdominal girth, which is referred to as distension. The pathophysiology of these two phenomena is somewhat different and it is now recognised that a whole variety of overlapping mechanisms are involved. Some of these are potentially amenable to treatment by modification of the bacterial flora of the gut and this article reviews the evidence for this.

The role of aggregation of ferrite nanoparticles on their magnetic properties.

We have studied the magnetic properties of aggregates of Mn0.5Zn0.5Gd(x)Fe(2-x)O4 ferrite nanoparticles, with x = 0.01, 0.02, 0.03, 0.04, 0.05, 0.06, 0.07, 0.08, 0.09, 0.10, 0.11, 0.12, 0.13, 0.14, 0.15, 0.16, 0.18, 0.20. The scanning electron microscopy micrographs show significant aggregation of the nanoparticles in all samples. Zero field cooled and field cooled magnetization measurements were conducted on all samples from 400 K down to 5 K. Most zero field cooled curves were found to exhibit the usual behavior but with wide peaked regions. For some x values, the field cooled magnetization was found to increase slowly with decreasing temperature, and becomes nearly constant at low temperatures. The measurements of magnetization versus applied magnetic field were conducted on all samples at 5 K and 305 K in the field range from -15000 to 15000 Oe. At 305 K the magnetization for all samples was observed to saturate, while at 5 K the magnetization did not reach saturation for some values of x. The saturation magnetization values were suggested to be proportional to the size of particles. These results were discussed and suggested to be due to the inter-particle dipolar and exchange interactions between the particles in the aggregates, the large particle size distribution and the surface magnetization effects.

Delusional disorder-somatic type (or body dysmorphic disorder) and schizophrenia: a case report.

With regard to delusional disorder-somatic subtype there may be a relationship with body dysmorphic disorder. There are reports that some delusional disorders can evolve to become schizophrenia. Similarly, the treatment of such disorders with antipsychotics has been documented. This report describes a case of delusional disorder - somatic type - preceding a psychotic episode and its successful treatment with an antipsychotic drug, thus contributing to what has been documented on the subject.

Genital self-mutilation.

We present a case report of a 22-year-old Nigerian student who presented to the accident and emergency unit of a Nigerian Teaching Hospital with a history of self-inflicted genital injury following a suicide attempt. He had background history of predisposition to depressive illness, a current diagnosis of a major depressive disorder, and had had two attempted suicidal episodes in the last 3 months prior to this event. The clinical finding shows a patient with sad affect, feeling of hopelessness, and worthlessness; however, the vital signs remained fairly stable. At examination under anesthesia, the testes were exposed and the right already self-castrated. The penis was degloved to the level of the Buck's fascia with intact corpora cavernosa and urethra. He had surgical excision of the hanging self-castrated right testis with debridement and primary closure of the genital laceration. He was promptly reviewed by the psychiatrists who co-managed appropriately.

Prevalence of psychiatric morbidity among inmates of a borstal institution in Nigeria.

Studies have reported increased psychiatric morbidity among young detainees, with as many as three-quarters reported to have one or more psychiatric disorders. Despite this, however, there is a dearth of published work among young inmates of prisons, remand homes or borstal institutions in Nigeria. The aim of this study was to assess possible psychiatric morbidity among young inmates of a borstal institution in Nigeria and to determine the factors that may be associated with this morbidity. Fifty-three inmates of one of the two existing borstal institution in Nigeria were assessed for psychiatric morbidity using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scores were compared with the socio-demographic factors of the respondents. Twenty-eight (52.8%) of the inmates were over 18 years old, 35.8% were in the middle position within the family, 62.3% were of Christian faith, and 64.2% had their parents still living together. Seventeen (32.1%) of the inmates were from Hausa ethnic extraction, 58.5% stayed for more than 6 months at the borstal institution, and 81.1% were brought to the institution by their parents. The mean age of the inmates was 17.3 years (range, 14-23 years) and 26 (49.1%) of them were GHQ-positive. There was no statistically significant difference between the mean age of GHQ-positive and GHQ-negative inmates (F=1.73, p=0.19), and none of the socio-demographic variables were significantly associated with psychiatric morbidity (i.e. GHQ-12 positivity). The study observed a high prevalence of undetected psychiatric morbidity among inmates at the borstal institution. Efforts should be intensified by the authority responsible for managing the Nigerian prison services (including the borstal institutions) to improve mental health services.

Diagnostic yield and grading acid-fast bacilli from serial sputum smears of HIV- infected and uninfected tuberculosis patients in routine microscopy laboratory in Ouagadougou, Burkina Faso

We compared 100 HIV-infected and 100 non-infected adult patients with pulmonary tuberculosis (TB) to evaluate the association between the HIV status and the microscopic yield, and between the HIV status and the grading of acid-fast bacilli (AFB) sputum smears. We stained specimens by Ziehl-Neelsen hot method. The first serial sputum smears diagnosed 89 por cento HIV- infected and 94 por cento uninfected. The additional yields of the second and third sputum smears identified respectively 10 por cento and 1 por cento among the HIV-infected against 5 por cento and 1 por cento among the patients without HIV. Considering grading of AFB, the HIV- positive patients were more scanty and less positive 2+ and 3+ at the first (P=0.089) and the second sputum smears (P=0.010). For the second AFB-smears grading, there was a significant difference between HIV-infected and uninfected among the males (P=0.031), the group of age ranging from 15 to 44 years old (P=0.003) and among the ambulatory patients (P=0.015); when we analyzed data for subgroups by HIV serological status, the difference was not significant in the results among the females (P=0.417) and the TB-hospitalized (P=0.501). In conclusion, the morning sputum smears improved the diagnostic yield in both HIV-infected and uninfected patients. However, globally the frequency of scanty was significantly associated with HIV serological status.

Comparison of targeted and whole genome analysis of postnatal specimens using a commercially available array based comparative genomic hybridisation (aCGH) microarray platform.

PURPOSE: The University of Utah Comparative Genomic Hybridization Microarray Laboratory was one of the first US laboratories to offer comparative genomic hybridisation (CGH) microarray testing using a commercial platform in a clinical setting. Results for 1076 patients (1598 chips) are presented. METHODS: The Spectral Genomics/PerkinElmer Constitutional Chip (targeted array), SpectralChip 2600 (whole genome array) and a "Combo" chip (both arrays run simultaneously) were the tests offered. Abnormal results were confirmed by an alternative method, most often fluorescence in situ hybridisation. RESULTS: In 669 cases with known normal cytogenetics, an abnormal detection rate of 10.8% was observed, (5.3%, 12.2% and 14.1% for the Constitutional Chip, SpectralChip 2600 and Combo assay, respectively). Known copy number variants and single clone abnormalities are not included in these rates. Single clone abnormalities are reported separately. For 1076 total cases, we report an average abnormal rate of 16.9% (8.7%, 23.7% and 18.6% for the three assays). This rate includes characterisation of some abnormalities previously identified by cytogenetics. CONCLUSIONS: CGH microarray provides a likely aetiology for the clinical phenotype in many cytogenetically normal cases, and a whole genome array generally identifies copy number changes more effectively than a targeted chip alone.

Predictors of psychiatric readmissions to the psychiatric unit of a tertiary health facility in a Nigerian city - a 5-year study.

OBJECTIVE: Little is known about predictors of readmission of psychiatric patients in the study environment. Knowledge of this, we believe could aid effective management of psychiatric patients, as well as judicious and equitable utilization of the limited mental health facilities in the North-central zone. The aim was to identify factors that may be predictive of readmissions to an in-patient psychiatric facility of a Nigerian University Teaching Hospital. METHOD: A retrospective record review of all admissions and discharges to/from the psychiatric inpatient ward of University of Ilorin Teaching Hospital, (UITH) between May 2000 and April 2005. Patients and clinical characteristics were recorded and all the data were characterized according to age, gender, marital status, occupational status, length of stay on admission, number of admissions, and medication compliance. Data were analyzed with SPSS version 11 to derive the chi square figures, Pearson's correlation, and logistic regression. The level of statistical significance was set at 5%. RESULTS: Within the study period, 41.4% of cases were readmissions. Young age, longer length of stay, multiple admissions and the diagnosis of schizophrenia were predictive of readmission while medication non-compliance was not predictive. CONCLUSION: Provision of psycho-education to both the patients and their families, identification of early symptoms of relapse, application of immediate and appropriate measures, and adequate record-keeping by health institutions are advocated.

The development of hypophosphataemic osteomalacia with myopathy in two patients with HIV infection receiving tenofovir therapy.

We report two cases in which osteomalacia developed in patients on tenofovir-containing highly active antiretroviral therapy (HAART) in the context of Fanconi syndrome with hypophosphataemia. Bone pain was the presenting feature and myopathy followed in one case. Disability was reversed with withdrawal of the drug and with mineral supplementation. The cases highlight the importance of considering the diagnosis of osteomalacia in patients treated with tenofovir. A possible association with incipient acute renal failure, particularly during nonsteroidal anti-inflammatory drug (NSAID) use, needs further investigation.

Blockade of platelet-derived growth factor receptor-beta by CDP860, a humanized, PEGylated di-Fab', leads to fluid accumulation and is associated with increased tumor vascularized volume.

PURPOSE: CDP860 is an engineered Fab' fragment-polyethylene glycol conjugate, which binds to and blocks the activity of the beta-subunit of the platelet-derived growth factor receptor (PDGFR-beta). Studies in animals have suggested that PDGFR-beta inhibition reduces tumor interstitial fluid pressure, and thus increases the uptake of concomitantly administered drugs. The purpose of this study was to determine whether changes in tumor vascular parameters could be detected in humans, and to assess whether CDP860 would be likely to increase the uptake of a concurrently administered small molecule in future studies. PATIENTS AND METHODS: Patients with advanced ovarian or colorectal cancer and good performance status received intravenous infusions of CDP860 on days 0 and 28. Patients had serial dynamic contrast-enhanced magnetic resonance imaging studies to measure changes in tumor vascular parameters. RESULTS: Three of eight patients developed significant ascites, and seven of eight showed evidence of fluid retention. In some patients, the ratio of vascular volume to total tumor volume increased significantly (P < .001) within 24 hours following CDP860 administration, an effect suggestive of recruitment of previously non-functioning vessels. CONCLUSION: These observations suggest that inhibition of PDGFR-beta might improve delivery of a concurrently administered therapy. However, in cancer patients, further exploration of the dosing regimen of CDP860 is required to dissociate adverse effects from beneficial effects. The findings challenge the view that inhibition of PDGF alone is beneficial, and confirm that effects of PDGFR kinase inhibition mediate, to some extent, the fluid retention observed in patients treated with mixed tyrosine kinase inhibitors.

Isolation and characterization of polycyclic aromatic hydrocarbon-degrading Mycobacterium isolates from soil.

Bioremediation of soils contaminated with wood preservatives containing polycyclic aromatic hydrocarbons (PAHs) is desired because of their toxic, mutagenic, and carcinogenic properties. Creosote wood preservative-contaminated soils at the Champion International Superfund Site in Libby, Montana currently undergo bioremediation in a prepared-bed land treatment unit (LTU) process. Microbes isolated from these LTU soils rapidly mineralized the (14)C-labeled PAH pyrene in the LTU soil. Gram staining, electron microscopy, and 16S rDNA-sequencing revealed that three of these bacteria, JLS, KMS, and MCS, were Mycobacterium strains. The phylogeny of the 16S rDNA showed that they were distinct from other Mycobacterium isolates with PAH-degrading activities. Catalase and superoxide dismutase (SOD) isozyme profiles confirmed that each isolate was distinct from each other and from the PAH-degrading mycobacterium, Mycobacterium vanbaalenii sp. nov, isolated from a petroleum-contaminated soil. We find that dioxygenase genes nidA and nidB are present in each of the Libby Mycobacterium isolates and are adjacent to each other in the sequence nidB-nidA, an order that is unique to the PAH-degrading mycobacteria.

Cytogenetic-clinicopathologic correlations in rhabdomyosarcoma: a report of five cases.

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children younger than the age of 15 years. Histologically, RMS can be subdivided into two major subtypes; embryonal (E-RMS) and alveolar (A-RMS) rhabdomyosarcoma, with E-RMS being the more common. Although cytogenetic and molecular genetic findings have been reported extensively for RMS, clinicopathologic-genetic correlations among these tumors have not been reported in detail. In this report, we correlate the cytogenetic findings, including fluorescence in situ hybridization and spectral karyotyping, with pathologic findings and outcome for five RMS, including two A-RMS, one E-RMS, one botryoid RMS, and one anaplastic nonclassified RMS (N-RMS). The findings in A-RMS and E-RMS generally were consistent with previous reports; however, gain of chromosome 7 in A-RMS and gain of chromosome 9 segments in E-RMS observed here have seldom been reported in the literature. Importantly, the botryoid RMS had a cytogenetic profile similar to other types of E-RMS. An add(11)(q21) observed in this tumor, together with a t(8;11)(q12 approximately 13;q21) reported previously, indicates that 11q21 rearrangements may be nonrandomly related to botryoid RMS. In addition, the N-RMS expressed a cytogenetic pattern similar to that observed in E-RMS, thus providing genetic evidence that anaplastic N-RMS is a variant of E-RMS. Finally, these cases provide cogent evidence for the diagnostic and prognostic significance of the pathologic-genetic classification of RMS.