RESUMEN
Researchers worldwide with information about the Kirsten ras (Ki-ras) tumour genotype and outcome of patients with colorectal cancer were invited to provide that data in a schematized format for inclusion in a collaborative database called RASCAL (The Kirsten ras in-colorectal-cancer collaborative group). Our results from 2721 such patients have been presented previously and for the first time in any common cancer, showed conclusively that different gene mutations have different impacts on outcome, even when the mutations occur at the same site on the genome. To explore the effect of Ki-ras mutations at different stages of colorectal cancer, more patients were recruited to the database, which was reanalysed when information on 4268 patients from 42 centres in 21 countries had been entered. After predetermined exclusion criteria were applied, data on 3439 patients were entered into a multivariate analysis. This found that of the 12 possible mutations on codons 12 and 13 of Kirsten ras, only one mutation on codon 12, glycine to valine, found in 8.6% of all patients, had a statistically significant impact on failure-free survival (P = 0.004, HR 1.3) and overall survival (P = 0.008, HR 1.29). This mutation appeared to have a greater impact on outcome in Dukes' C cancers (failure-free survival, P = 0.008, HR 1.5; overall survival P = 0.02, HR 1.45) than in Dukes' B tumours (failure-free survival, P = 0.46, HR 1.12; overall survival P = 0.36, HR 1.15). Ki-ras mutations may occur early in the development of pre-cancerous adenomas in the colon and rectum. However, this collaborative study suggests that not only is the presence of a codon 12 glycine to valine mutation important for cancer progression but also that it may predispose to more aggressive biological behaviour in patients with advanced colorectal cancer.
Asunto(s)
Neoplasias Colorrectales/genética , Bases de Datos Factuales , Genes ras/genética , Mutación Puntual , Sistema de Registros , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Codón/genética , Neoplasias Colorrectales/mortalidad , Supervivencia sin Enfermedad , Femenino , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Mutación Missense , Estadificación de Neoplasias , Modelos de Riesgos Proporcionales , Análisis de Supervivencia , Valina/genéticaRESUMEN
A case of eosinophil peroxidase deficiency is described after fortuitous detection by the H*3 Technicon hematological analyzer. From the cytochemical aspect total deficiency is admitted. The abnormality is thought to be extremely rare in a well-mixed population as exists in the Grand-Duchy of Luxembourg.
Asunto(s)
Eosinófilos/enzimología , Peroxidasa/deficiencia , Anciano , Anciano de 80 o más Años , Recuento de Células , Humanos , Masculino , Coloración y EtiquetadoRESUMEN
The authors have reviewed two of Kuntscher's principles relating to intramedullary nailing: the moment of elasticity of the nail should be close to the moment of elasticity of the bone and the suppression of rotation movements at the fracture site is due to locking of the nail by virtue of its elasticity. They have conducted an experimental study which does not confirm these views. They considered that rotary stability is due to muscle tone, the line of the fracture and the anchorage of the ends of the nail at the upper and lower end of the bone.
Asunto(s)
Fijación Intramedular de Fracturas/métodos , Clavos Ortopédicos , Huesos/fisiopatología , Elasticidad , Fracturas Óseas/fisiopatología , Humanos , Tono Muscular , RotaciónRESUMEN
Among cases of recent or long-standing post-traumatic laxity of the knee ligaments, unstable lateral rotation is due to a well-defined anatomical lesion, viz. Rupture of the medial capsular ligament of the knee. This laxity is demonstrated clinically by the existence of an abnormal postero-anterior movement when the tibia is in lateral rotation. Its surgical treatment, suggested by D. Slocum, consists of displacement of the patella tendon. This rupture may exist alone but, usually, is associated with other ligamentous or meniscal lesions for which further specific treatment should be carried out. Slocum's operation has recently been used in the Strasburg Accident Centre. The early results are encouraging.