Impact of CD44 genetic variants on clinicopathological characteristics of uterine cervical cancer patients.

CD44 genetic variants have been found to be related to various cancers. However, to date, no study has demonstrated the involvement of CD44 polymorphisms in uterine cervical cancer in Taiwanese women. Therefore, we conducted a retrospective study, consecutively recruiting 113 patients with invasive cancer, 92 patients with high-grade cervical intraepithelial neoplasias, and 302 control women to assess the relationships among CD44 polymorphisms, cervical carcinogenesis, and patient survival. Real-time polymerase chain reaction was used to determine the genotypic distributions of six polymorphisms: rs1425802, rs187115, rs713330, rs11821102, rs10836347, and rs13347. The results revealed that women with the mutant homozygous genotype CC exhibited a higher risk of invasive cancer compared to those with the wild homozygous genotype TT [p=0.035; hazard ratio (HR)=10.29, 95% confidence interval (95% CI)=1.18-89.40] and TT/TC [p=0.032; HR=10.66, 95% CI=1.23-92.11] in the CD44 polymorphism rs713330. No significant association was found between CD44 genetic variants and clinicopathological parameters. Among the clinicopathological parameters, only positive pelvic lymph node metastasis (p=0.002; HR=8.57, 95% CI=2.14-34.38) and the AG/GG genotype compared to AA (p=0.014; HR=3.30, 95% CI=1.28-8.49) in CD44 polymorphism rs187115 predicted a higher risk of poor five-year survival, according to multivariate analysis. In conclusion, an important and novel finding revealed that Taiwanese women with the AG/GG genotype in CD44 polymorphism rs187115 exhibited a higher risk of poor five-year survival.

Endoscopic stenting for chronic recurrent pancreatitis in a child.

Chronic pancreatitis in childhood is a rare but potentially debilitating disorder. Conservative therapy frequently fails, so that recurrent attacks are common. Traditional therapy often culminates in longitudinal pancreaticojejunostomy and distal pancreatectomy with Roux-en-Y pancreaticojejunostomy. We report a 9-year-old girl who had recurrent pancreatitis accompanied by multiple pancreatic cysts with stones in the pancreatic duct. She had been admitted complaining of abdominal pain. Abdominal sonography showed a dilated pancreatic duct and enlarged polycystic kidneys bilaterally. On abdominal computed tomography, there was a suspicion of a calcified shadow in a swollen pancreatic head, along with significant dilatation of the pancreatic duct in the body and the tail. With conservative treatment, the symptoms improved but relapsed 4 months later. Abdominal CT showed progressive abnormalities in the pancreas. ERCP with papillosphincterotomy was performed, resulting in the efflux of pus and stones. A stent was placed in the main pancreatic duct, which dramatically improved the patient's symptoms. We recommend endoscopic stent placement therapy in children with chronic pancreatitis with stones as an alternative to extensive surgery.

Multiple congenital anomalies in association with supernumerary chromosome 47 inherited from a maternal balanced translocation.

Tertiary trisomy is uncommon and may arise only when one of the derivatives is small and, in the abnormal individual with karyotype 47, exists as a supernumerary derivative chromosome (+der). We describe a case of 47, XY, +der(9)t(5;9) (q33.1;q13)mat. The patient (a 1-day-old male) presented with multiple congenital anomalies including microcephaly, wide fontanelles and sutures, microphthalmia, deep-set eyes, short palpebral fissures, bulbous nose, wide nasal bridge, high arched palate, low-set and posteriorly rotated ears, micrognathia, short neck, ptosis, patient ductus arteriosus, hypoplastic external genitalia, cryptorchidism, inguinal hernia, flexion contractures of joints, short stature, clenched hands, rocker-bottom feet, simian crease, distal mottling of the skin, nail hypoplasia, hypoplasia of bones and hydrocephalus. The supernumerary derivative chromosome resulted from a meiotic recombination of a maternal balanced translocation, t(5;9) (q33.1;q13), suggesting that 3:1 disjunction in the oocyte occurred.

Community-acquired disseminated methicillin-resistant Staphylococcus aureus infection: case report and clinical implications.

A 6-year-old girl with community-acquired disseminated infection caused by methicillin-resistant Staphylococcus aureus (MRSA) is described. She had sepsis, meningo-encephalitis, pyomyositis, osteomyelitis, pericarditis and pulmonary embolisation caused by a multi-resistant strain of MRSA. Vancomycin is not routinely recommended as the first-line antimicrobial agent for suspected Staphylococcus aureus infection; however, it should be considered pending susceptibility results in patients presenting with severe sepsis in areas where the prevalence of MRSA is high.