A novel polymorphism in intron 6 of the human p53 gene: a possible association with cancer predisposition and susceptibility.

We present a novel polymorphic 8-bp sequence in intron 6 of the p53 gene that maps between bp 55 and 62 of the 3' end of exon 6. Of normal blood samples, 32% were heterozygotic for this polymorphism and display a NN' genotype, whereas 68% of the population is homozygotic for the N genotype. The rare homozygotic genotype N' was detected only in four blood samples of cancer patients. Peripheral blood of gastrointestinal (GI) and breast tumor patients demonstrated a higher incidence of heterozygosity (50%) than that of normal individuals. Analysis of the distribution of this polymorphism in tumor samples showed loss of heterozygosity (LOH). This LOH during tumor progression could exhibit preference to each one of the polymorphic alleles. The rare presentation of one allele and the increased incidence of heterozygosity in carcinoma patients may suggest an association between this polymorphism with cancer predisposition and susceptibility. The fact that genetic alterations occurring in noncoding regions may play a role in tumor development only further increases the extent of involvement of p53 in carcinogenesis.

Surgical treatment of primary hyperhidrosis. A report of 42 cases.

Forty-two patients suffering from primary hyperhidrosis underwent upper dorsal sympathectomy using the supraclavicular approach. The postoperative course and results were devoid of complications. All the patients except one were satisfied with the results of surgery, which greatly improved the quality of their lives.

Carbon dioxide laser in the treatment of high anal fistula.

Three high anal fistulas were treated with a carbon dioxide laser beam. The laser vaporizes the tissue and, because of the accurate focus of the apparatus, causes no damage around the path of the beam. This method was used to core out the fistula tract, and resulted in good healing.

The feasibility of an ambulatory surgery service for military personnel.

In the past, ambulatory surgery has been considered unsuitable for military personnel. In this pilot study, 69 members of the Israel Defense Forces underwent a variety of surgical procedures on an ambulatory basis in a central, university-affiliated general hospital. The waiting time for surgery was considerably reduced. The patients, the army, and the hospital staff were satisfied with the service. Although further study is needed, ambulatory surgery appears to be a suitable and advantageous modality for military personnel.

[Laparoscopic cholecystectomy].

80 patients underwent laparoscopic cholecystectomy, of whom 64 were females and 16 males (age range 20-70 years) and 15 had undergone previous abdominal operations. 3 of the 80 operations were converted to open cholecystectomy. In 11, preoperative ERCP was performed, in 2 of whom common bile duct stones were detected. In 7 intraoperative cholangiography was performed. The average hospital stay was 2.2 days. Based on this and other studies, laparoscopic cholecystectomy seems to be the operation of choice for symptomatic cholelithiasis.

Angiodysplasia as a cause of colonic bleeding in the elderly.

Angiodysplasia is being recognized as a major causal factor of colonic haemorrhage in the elderly. Superior mesenteric arteriography in an 86-year-old lady with recurrent haemorrhage revealed the lesion. Confirmation of the diagnosis was made possible by the injection of contrast material into the blood vessels of the removed intestine and subsequent histological examination.

Cloacogenic carcinoma of the anus.

A case is presented of transitional-cell cloacogenic carcinoma -- a rare variant of anal canal malignancy that occurred in a 58-year-old woman. The characteristics of this tumor are discussed, and her prognosis after abdominoperineal resection and posterior colpectomy seems good.

Pseudoaneurysm of the dorsalis pedis artery.

Two cases of post-traumatic pseudoaneurysm of the dorsalis pedis artery are presented. Both were managed by resection and vascular reconstruction with a successful result. It is suggested that this, rather than resection and ligation, is the preferred treatment in these cases.

Colocutaneous fistula--a rare complication of percutaneous endoscopic gastrostomy.

Although the percutaneous endoscopic gastrostomy technique for feeding is a fairly common procedure now, we have not come across a complication such as described below, a probable migration of the tube from the stomach to the colon, without any objective proof for this.

Use of the carbon dioxide laser in an abdominoperineal resection for epidermoid anal carcinoma: a case report.

An abdominoperineal excision of the rectum was performed on a 52-year-old male who had epidermoid anal carcinoma. A steel scalpel was utilized for the abdominal component, but the entire perineal resection was accomplished with a carbon dioxide laser beam. We believe this to be the first reported case of an abdominoperineal resection using this new modality, which may become a useful and modern adjunct in extirpative surgery. The haemostatic effects of the laser were well demonstrated in our patient.

The everted rectal stump technique for the application of the distal pursestring suture in the construction of stapled anastomoses.

The everted rectal stump technique for the application of the distal pursestring suture was used successfully in three patients to perform a low stapled reconstructive anastomosis in the treatment of carcinoma of the rectum. Two of the patients were Dukes' Stage B and one patient was classified as Dukes' Stage C. The postoperative course was uneventful. There were no complications and all three were free of tenesmus and cutaneous irritation and were continent of flatus and feces, with one to three movements per day.