The imprinted H19 gene is a marker of early recurrence in human bladder carcinoma.

AIMS: To investigate the expression of the imprinted oncofetal H19 gene in human bladder carcinoma and to examine the possibility of using it as a tumour marker, similar to other oncofetal gene products. METHODS: In situ hybridisation for H19 RNA was performed on 61 first biopsies of bladder carcinoma from Hadassah Medical Centre in Jerusalem. The intensity of the reaction and the number of tumour cells expressing H19 in each biopsy were evaluated in 56 patients, excluding biopsies with carcinoma in situ. The medical files were searched for demographic data and disease free survival. RESULTS: More than 5% of cells expressed H19 in 47 of the 56 (84%) biopsies. There was a decrease in the number of cells expressing H19 with increasing tumour grade (loss of differentiation) (p = 0.03). Disease free survival from the first biopsy to first recurrence was significantly shorter in patients with tumours having a larger fraction of H19 expressing cells, controlling for tumour grade. This was also supported by the selective analysis of tumour recurrence in patients with grade I tumours. CONCLUSIONS: It might be possible to use H19 as a prognostic tumour marker for the early recurrence of bladder cancer. In addition, for the gene therapy of bladder carcinoma that is based on the transcriptional regulatory sequences of H19, the expression of H19 in an individual biopsy could be considered a predictive tumour marker for selecting those patients who would benefit from this form of treatment.

Accidental kerosene ingestion: a 3-year prospective study.

Accidental kerosene ingestion continues to cause morbidity and mortality in third world countries, where kerosene is still used for cooking, heating and cleaning. In this prospective study, 78 children aged from 10 months to 5 years were managed at Makassed Hospital in Jerusalem for kerosene ingestion. Respiratory distress developed in 60 (76.90%) children. Two who required mechanical ventilation died. Vomiting, which occurred in 49 cases, did not seem to increase the risk of respiratory complications, suggesting that aspiration occurs with the initial ingestion. Chest X-ray changes were noted in 60% of the children on admission. Pleural effusions occurred in three cases over 24 hours after the incident. CNS manifestations, most likely caused by anoxia, were seen in 27% of the children, but in only two were they severe in the form of convulsions, and both died. Fever occurred in about 50% of the children during their stay in hospital. Severe gastric dilatation developed in the four most severely ill children, two of whom died. The quantity of kerosene ingested by them was estimated to be large.