A MLH1 polymorphism that increases cancer risk is associated with better outcome in sporadic colorectal cancer.

Germline mutations or the malfunctioning of postreplicative mismatch repair genes (MMR) are responsible of hereditary nonpolyposis colorectal cancer (HNPCC), and are also implied in some sporadic colorectal cancer (CRC) forms without any familial history of this disease. Besides germinal mutations and methylation, single-nucleotide polymorphisms (SNP) can predispose to nonfamilial CRC with low to moderate penetrance. In this case-control study, we analyzed three MLH1 single-nucleotide polymorphisms (exon 5: 415G-->C, rs28930073; exon 8: 655A-->G, rs1799977 and exon 16: 1852-1853AA-->GC) in 140 sporadic colorectal cancer cases and 125 healthy individuals to evaluate the relationship among CRC risk and clinicopathologic and genetic characteristics of the tumors.

[PATHOS study on postoperative pain management in Europe: French data].

Introduction: Relief of postoperative pain is a major topic of public health and has been repeatedly shown to be inadequate.

Study Design: A questionnaire survey performed in seven European countries (postoperative analgesic therapy observational survey) in 746 health structures--which perform more than 80% of the total number of surgical procedures of each country--has demonstrated significant improvement when compared with previous surveys, particularly regarding increased use of multimodal analgesia and regular administration of analgesic drugs. The present study describes specific results for the 178 French health care institutions surveyed and 345 questionnaires collected.

Usefulness of laboratory data in the management of right iliac fossa pain in adults.

Purpose: This study examined the usefulness of inflammatory markers in the management of patients with right iliac fossa pain.

Patients And Methods: A single site, prospective observational study was conducted from October 2001 to April 2003. Patients with right iliac fossa pain referred to the surgeon were included.

Postoperative Analgesic THerapy Observational Survey (PATHOS): a practice pattern study in 7 central/southern European countries.

Surveys evaluating pain in hospitals keep on showing that postoperative pain (POP) remains undertreated. At the time when guidelines are edited and organisational changes are implemented, more recent data are necessary to check the impact of these measures on daily practice and needs for improvement. This prospective, cross-sectional, observational, multi-centre practice survey was performed in 2004-2005 in 7 European countries.

Do MSI-L sporadic colorectal tumors develop through "mild mutator pathway"?

Background: The mutator pathway implied in the development of colorectal cancer (CRC) is characterized by microsatellite instability (MSI). MSI tumors can be subdivided according to the level of instability: MSI-H (high), MSI-L (low) or stable MSS. MSI-H CRC displays a well described distinct phenotype, but the true biologic significance of MSI-L is still uncertain.

Wunderlichacute's syndrome due to rupture of a renal angiomyolipoma.

We present the clinical case of a 79 year-old patient with hypertension, treated with anticoagulants and known background of right renal angiomyolipoma that is admitted to the emergency ward due to pain and mass in right flank. The CT revealed retroperitoneal haematoma, active renal intratumoral bleeding and hemoperitoneum. A total emergency nephrectomy was carried out.

Genetic alterations and MSI status in primary, synchronous, and metachronous tumors in a family with hereditary nonpolyposis colorectal cancer (HNPCC).

In colorectal cancer, different levels of microsatellite instability (MSI) have been described: high-frequency MSI, low-frequency MSI, and stable microsatellites. MSI-H characterizes a unique clinical and pathologic phenotype known as hereditary nonpolyposis colorectal cancer syndrome (HNPCC). In this case, an increased incidence of synchronous and metachronous tumors has been reported, but there are few reports with standardized criteria of MSI in HNPCC-associated tumors.

Self-expandable stent before elective surgery vs. emergency surgery for the treatment of malignant colorectal obstructions: comparison of primary anastomosis and morbidity rates.

Purpose: At present there are not enough studies that demonstrate the usefulness of self-expandable stents in patients with left-sided malignant colon and rectal obstruction. We evaluated primary anastomosis and morbidity rates obtained with this method in comparison with the results of the emergency surgical treatment.

Methods: From February 1994 to November 1999, 72 consecutive patients with left-sided malignant colorectal obstruction were enrolled.

Lipoma of the liver associated with hepatocellular carcinoma and polycystic liver disease.

Background/aims: We report on a patient with lipoma of the liver associated with hepatocellular carcinoma (HCC) and polycystic liver disease.

Methods: Clinical features of a patient with lipoma, HCC and polycystic liver disease are presented. A right liver lobectomy was performed.

Colocutaneous fistula due to polypropylene mesh.

Fistulae due to polypropylene mesh are known to occur if the prosthetic mesh is placed close to a hollow viscus. Some cases of enterocutaneous fistula have been reported but there are few cases of fistula affecting the large bowel. It is important to recognize these cases because they are severe complications of the prosthesis and difficult to manage.

Liver hematoma following endoscopic retrograde cholangiopancreatography (ERCP).

We report the case of an 81-year-old man who presented with abdominal pain following endoscopic retrograde cholangiopancreatography (ERCP) for choledocholithiasis. A diagnosis of infected hematoma was made. A CT-guided puncture produced bloody matter that grew Citrobacter freundii.

Prognostic significance of high microsatellite instability in a Spanish series of gastric adenocarcinomas.

In colorectal cancer different levels of microsatellite instability (MSI) have been described. MSI-H (high) characterizes a unique clinical and pathological phenotype known as hereditary non-polyposis colorectal cancer syndrome, whereas MSI-L (low) and MSS (stable) are considered similar phenotypes without pathological implications. MSI has been also described as a frequent genetic alteration in a subset of gastric adenocarcinomas.

Dehiscence of gastrojejunal stapled anastomosis after lithotripsy for nephrolithiasis.

We report the case of a 76-year-old woman with previous bariatric surgery and a large renal calculus following a prolonged lithotripsy session. The patient presented with peritonitis due to dehiscence of the gastrojejunal stapled anastomosis.

Antiemetic efficacy of ondansetron in laparoscopic cholecystectomy. A randomized, double-blind, placebo-controlled study.

Objective: to assess the effectiveness of ondansetron in preventing postoperative nausea and vomiting after elective laparoscopic cholecystectomy, and the effect of this anesthetic on hospital stay.

Methods: this randomized, double-blind, placebo-controlled study was done in the General Surgery Service of the Getafe University Hospital. Patients who were scheduled for laparoscopic cholecystectomy to treat uncomplicated cholelithiasis, and who had an ASA status of I-II, were recruited.

Self-expanding prostheses as a palliative method in treating advanced colorectal cancer.

Aim: This work presents the results of the use of self-expanding prosthesis as a definitive palliative method for eliminating colorectal obstructions caused by advanced and unresectable tumours.

Patients: A total of 41 cases were included (29 men, 12 women) with an average age of 70.12 years (range 46-95 years).

Rectovesical fistula treated by covered self-expanding prosthesis: report of a case.

Postoperative rectovesical fistulas require surgical intervention for their treatment. We present a case treated by placement of a silicone self-expanding prosthesis in the rectum and vesical drainage and give technical details of the procedure.

Loss of heterozygosity of TP53 is not correlated with clinicopathological variables in sporadic colorectal carcinomas.

We have analyzed the loss of heterozygosity (LOH) of TP53 in a series of 96 sporadic colorectal carcinomas by means of PCR, using two microsatellite sequences (TP53 and Mfd152), to investigate its possible relationship with several clinicopathological variables in the Spanish population. Forty six of the 96 patients (48%) showed loss of one allele of the microsatellite TP53, Mfd152 or both, when compared with normal colorectal mucosae and blood samples of the same patient. This high percentage of LOH seems to corroborate the important role of p53 in sporadic colorectal cancer.