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Scand J Gastroenterol. 2000 Nov;35(11):1194-9.
Anal carcinoma: a 15-year retrospective analysis.

Olofinlade O, Adeonigbagbe O, Gualtieri N, Gingold B, Berlin I, Sayeed R, Robilotti J.

Dept. of Medicine, St Vincent's Hospital, New York, NY 10011, USA.

BACKGROUND: Using a 15-year experience in two teaching hospitals to illustrate the clinicopathologic, treatment and survival characteristics of cloacogenic and squamous cell carcinoma of the anus. METHOD: A retrospective analysis over a 15-year period from St Vincent's Hospital (SVH) and the Catholic Medical Center (CMC) in New York City. The patients in the study all had a diagnosis of either squamous or cloacogenic cell carcinoma of the anus. RESULTS: Cloacogenic and squamous cell carcinoma accounted for 2.5% of all large bowel cancers. In the population sample, 28/92 (30.4%) were of the cloacogenic type and 64/92 (69.6%) were of the squamous cell type. The male-to-female ratio was 1:1.5 in those with cloacogenic cancer and 1.8:1 in those with squamous cell carcinoma. The mean age of presentation was 57 +/- 2.8 years for the squamous cell carcinoma patients and 66.3 +/- 3.4 years in those with cloacogenic carcinoma (P < 0.02); 3/28 (10.7%) of patients with cloacogenic cancer were human immune deficiency virus (HIV) positive while 15/64 (23.4%) of the squamous cell cancer patients were HIV positive. The most common clinical presentation in both groups were rectal bleeding, pain, constipation and the presence of an anal mass. Of patients with squamous cell cancer 25% had evidence of infection with the human papilloma virus (HPV) while none of those with cloacogenic cancer had evidence of HPV infection (P < 0.0005). The treatment modality and survival were similar in both histologic groups. The most important factors that affect survival in both groups are female sex and stage of disease. CONCLUSION: Cloacogenic and squamous cell carcinoma account for only a small proportion of large bowel cancers. The squamous cell type is the more common type and presents at a younger age in both sexes. The squamous cell type is also more common in males and is associated with human papilloma and HIV infection. Treatment modality and survival is, however, similar in both histologic variants of anal cancer.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11145292&dopt=Abstract

Clin Genet. 2000 Dec;58(6):483-7.
A boy with a submicroscopic 22qter deletion, general overgrowth and features suggestive of FG syndrome.

de Vries BB, Bitner-Glindzicz M, Knight SJ, Tyson J, MacDermont KD, Flint J, Malcolm S, Winter RM.

Department of Clinical and Molecular Genetics, Institute of Child Health and Great Ormond Street Hospital, London, UK.

Over recent years, submicroscopic subtelomeric rearrangements have been shown to be a significant cause of mental retardation and, therefore, such abnormalities should be considered in every child with moderate to severe retardation with additional features suggestive of a chromosomal abnormality. The FG syndrome is an X-linked recessive mental retardation syndrome with congenital hypotonia, relative macrocephaly, a characteristic facies and constipation. We describe a severely mentally retarded boy with a history of severe constipation, truncal hypotonia, facial dysmorphism, fetal pads, and joint laxity, leading to an initial diagnosis of FG syndrome at the age of 3 years. Clinical re-evaluation at the age of 6 years, when he showed signs of general overgrowth, initiated a telomere screen, and a submicroscopic 22q13.3 telomere deletion was detected. The features suggestive of FG syndrome in this boy with a 22q13.3--> qter deletion may indicate testing for submicroscopic 22qter deletions in patients with atypical features of FG syndrome without a definite X-linked family history.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11149619&dopt=Abstract

Med Dosim. 2000 Winter;25(4):237-41.
The effect of constipation on rectal dosimetry following prostate brachytherapy.

Merrick GS, Butler WM, Dorsey AT, Dorsey JT 3rd.

Schiffler Oncology Center, Wheeling Hospital, Wheeling, WV 26003-6300, USA. oncologgo.net

The purpose of this study is to report the effect of dilatation of the anorectum on rectal dosimetry following an 125I prostate implant. Three months following prostate brachytherapy, 2 computed tomography (CT) scans of the prostate gland were obtained within 90 minutes of each other. The first CT scan revealed a dilated anorectum secondary to constipation. The second CT was obtained following the administration of an enema with a successfully evacuated rectum. Differences in radiation doses to the distended and empty rectum were computed via the mean dose, the maximum dose per slice, the distance from the base, and in terms of the surface of the anterior quadrant of the rectum receiving 100%, 125%, 150%, 175%, 200%, and 250% of the prescribed dose. The dose to the rectal wall was substantially increased in the distended state for all evaluated parameters. In general, the mean dose to the rectal wall was increased by a factor of 1.5 in the distended state. In both scenarios, the dose to the rectal wall peaked near midgland. In terms of 10 degrees rectal wall sectors receiving a given percentage of the prescribed minimal peripheral dose, S%mPD, the S100, S125, S150, S175, S200, and S250 were substantially greater for the distended versus the empty rectum. The magnitude of the percentage difference in dose between the distended and evacuated rectum increased with dose level while the difference in the number of sectors receiving a given dose level was greatest at 125% and 150% of the prescribed dose. We recommend detailed postimplant attention to bowel habits for at least 2 half-lives of the implanted isotope to minimize rectal distention, decrease radiation dose to the anterior rectal wall, and subsequently minimize potential constipation related rectal toxicity.

online pharmacy ref. source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11150696&dopt=Abstract

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