Faisal Al-Mashat

Effect of BRAF mutational status on expression profiles in conventional papillary thyroid carcinomas

BackgroundWhereas 40 % to 70 % of papillary thyroid carcinomas (PTCs) are characterized by a BRAF mutation (BRAFmut), unified biomarkers for the genetically heterogeneous group of BRAF wild type (BRAFwt) PTCs are not established yet. Using state-of-the-art technology we compared RNA expression profiles between conventional BRAFwt and BRAFmut PTCs.MethodsMicroarrays covering 36,079 reference sequences were used to generate whole transcript expression profiles in 11 BRAFwt PTCs including five micro PTCs, 14 BRAFmut PTCs, and 7 normal thyroid specimens. A p-value with a false discovery rate (FDR) < 0.05 and a fold change > 2 were used as a threshold of significance for differential expression. Network and pathway utilities were employed to interpret significance of expression data. BRAF mutational status was established by direct sequencing the hotspot region of exon 15.ResultsWe identified 237 annotated genes that were significantly differentially expressed between BRAFwt and BRAFmut PTCs. Of these, 110 genes were down- and 127 were upregulated in BRAFwt compared to BRAFmut PTCs. A number of molecules involved in thyroid hormone metabolism including thyroid peroxidase (TPO) were differentially expressed between both groups. Among cancer-associated molecules were ERBB3 that was downregulated and ERBB4 that was upregulated in BRAFwt PTCs. Two microRNAs were significantly differentially expressed of which miR492 bears predicted functions relevant to thyroid-specific molecules. The protein kinase A (PKA) and the G protein-coupled receptor pathways were identified as significantly related signaling cascades to the gene set of 237 genes. Furthermore, a network of interacting molecules was predicted on basis of the differentially expressed gene set.ConclusionsThe expression study focusing on affected genes that are differentially expressed between BRAFwt and BRAFmut conventional PTCs identified a number of molecules which are connected in a network and affect important canonical pathways. The identified gene set adds to our understanding of the tumor biology of BRAFwt and BRAFmut PTCs and contains genes/biomarkers of interest.

RECTAL CANCER ASSOCIATED WITH SCHISTOSOMIASIS: REPORT OF TWO CASES AND REVIEW OF THE LITERATURE

Rectal cancer is one of the most common malignancies in the West. The incidence in the developing countries is also increasing. There are various reasons for this escalation, including changes in dietary habits, particularly among urban dwellers, and parasitic infections. The risk of colorectal cancer is known to be increased in patients with long-standing schistosomal colitis. We present two male patients who had low rectal cancer (pT3N3M0, and pT3N2M0) for which they were treated with A-P resection and adjuvant chemoradiation. Histological examination of the specimen revealed moderately differentiated adenocarcinoma with extensive schistosomal colitis. The literature was reviewed. The relation between colorectal cancer and intestinal schistosomiasis should be considered as precancerous.

Simultaneous medullary-papillary thyroid carcinoma.

Differentiated thyroid carcinoma is the commonest malignancy affecting the thyroid gland. Medullary thyroid carcinoma accounts for 5% to 10% of all thyroid neoplasms. In recent years, a combination of medullary-follicular and medullary-papillary carcinomas has been reported, with immunoreactivity for calcitonin and thyroglobulin.1 This is a rare association with an unclear histogenesis. We describe a case of medullary-papillary carcinoma in a female patient who presented with respiratory distress due to a huge goiter and was treated by lobectomy and isthmectomy.

Is Laparoscopic Appendectomy a Safe Procedure? A Single Surgeon Experience at a University Hospital@@@هل إزالة الزائدة الدودية بالمنظار طريقة مأمونة؟ خبرة جراح مناظير في مستشفى جامعى

The aim of this retrospective study was to evaluate the safety and benefits of laparoscopic appendectomy performed by a single surgeon at a university hospital and compare the results with other similar studies. The medical records of 113 patients with suspected appendicitis who underwent laparoscopic appendectomy (January 2003 to December 2004) were analyzed for demographic information, clinical findings, laboratory / ultrasound results, intraoperative diagnosis, clinicopathologic correlation, complications, incidental findings, and operative time. A pelvic ultrasound was done for 36 (31.8%) patients. All patients received prophylactic antibiotics and none had drain. All appendices were removed whether they were inflamed or not. Pregnant patients were excluded from this study. There were 60 males and 53 females; with mean age 24.05 years. The mean operative time was 62.21 minutes. Conversion to open appendectomy was done in 8 (7.1%) patients. Post-operative complications occurred in 14 (12.4%) patients. The appendix was inflamed in 102 (90.26%) patients. The mean hospital stay was 2.35 days and there was no mortality. Laparoscopic appendectomy is a safe procedure with acceptable complications without mortality. It is advocated as the procedure of choice for patients with suspected appendicitis.