Retroperitoneal liposarcomas: The experience of a tertiary Asian center

10.1186/1477-7819-9-12World Journal of Surgical Oncology9

Dynamic Reconstruction of Anal Sphincter with Camera Shutter Style Double-Opposing Gracilis Flaps

Fournier's gangrene is a life-threatening infection which requires prompt recognition, early surgical debridement of unhealthy tissue, and initiation of broad-spectrum antibiotics. Relook debridement are usually performed until all the devitalized tissue has been removed. Involvement of the anal sphincter may result in significant morbidity such as permanent incontinence. Dynamic reconstruction of the anal sphincter has always been one of the holy grails in the field of pelvic reconstruction

Patient Preferences and Predicted Relative Uptake for Targeted Therapies in Metastatic Colorectal Cancer: A Discrete Choice Experiment

10.1080/03007995.2020.1790348Current Medical Research and Opinion36101677-168

Chromosome 19q13 disruption alters expressions of CYP2A7, MIA and MIA-RAB4B lncRNA and contributes to FAP-like phenotype in APC mutation-negative familial colorectal cancer patients.

Familial adenomatous polyposis (FAP) is an autosomal-dominantly inherited form of colorectal cancer (CRC) caused by mutation in the adenomatous polyposis coli (APC) gene. Our ability to exhaustively screen for APC mutations identify microsatellite-stable and APC-mutation negative familial CRC patients, enabling us to search for novel genes. We performed genome-wide scan on two affected siblings of one family and 88 ethnicity- and gender-matched healthy controls to identify deletions shared by the siblings. Combined loss of heterozygosity, copy number and allelic-specific copy number analysis uncovered 5 shared deletions. Long-range polymerase chain reaction (PCR) confirmed chromosome 19q13 deletion, which was subsequently found in one other family. The 32 kb deleted region harbors the CYP2A7 gene and was enriched with enhancer, repressor and insulator sites. The wildtype allele was lost in the polyps of the proband. Further, real-time RT-PCR assays showed that expressions of MIA and MIA-RAB4B located 35 kb upstream of the deletion, were up-regulated in the polyps compared to the matched mucosa of the proband. MIA-RAB4B, the read-through long non-coding RNA (lncRNA), RAB4B, PIM2 and TAOK1 share common binding site of a microRNA, miR-24, in their 3'UTRs. PIM2 and TAOK1, two target oncogenes of miR-24, were co-ordinately up-regulated with MIA-RAB4B in the polyps, suggesting that MIA-RAB4B could function as competitive endogenous RNA to titrate miR-24 away from its other targets. The data suggest that the 19.13 deletion disrupted chromatin boundary, leading to altered expression of several genes and lncRNA, could contribute to colorectal cancer via novel genetic and epigenetic mechanisms

Full-Dress Rehearsals with Actual Non-Infected Patients Builds Confidence and Familiarity – An Experience from Singapore during the COVID-19 Pandemic

Purpose COVID-19 has spread throughout the world with merciless pace. Personal protective equipment (PPE) is required to protect healthcare workers from contracting the virus. The authors evaluated the use of full-dress rehearsals (FDR) to familiarize staff with protocols and equipment that are not often use otherwise. Methods A single institution in Singapore performed FDR with noninfected patients for endoscopy after refresher courses with PPE were conducted. FDRs were conducted between February and March 2020, during the initial phase of the COVID-19 outbreak. The FDRs involved all phases of endoscopy. Statistics from the FDRs were compared against baseline procedure statistics. A self-administered survey was conducted for the procedurists after the FDRs. Results A total of 26 FDRs were conducted and 20 (77%) completed the survey. Among all the FDRs conducted, there was a slight increase in duration for colonoscopy FDRs (21.5 min vs 20.0 min, p = 0.22). There were no complications. All respondents had a good experience (score rating of 4-5/5). On qualitative analysis, the themes identified were:FDRs provided a good opportunity to have hands-on familiarization of the equipment on top of routine refresher training. Participants were cognizant of the ongoing outbreak and the evolving threat. Safety measures were reinforced. Procedurists who acknowledged weaknesses, requested for more training. Conclusions Simulation training with patients provides participants with a level of realism that is critical for rapid learning. In crisis management, the most effective protocol familiarization is important to instill confidence in the PPE, workflows and healthcare partners