Colorectal tumors mostly arise from sporadic adenomatous polyps. Polyps are defined as a mass of cells that protrudes into the lumen of the colon. Adenomatous polyps are benign neoplasms that, by definition display some characteristics of dysplasia. It has been shown that polyps were benign tumors which may undergo malignant transformation. Adenomatous polyps have been classified into three histologic types; tubular, tubulovillous, and villous with increasing malignant potential. The ability to differentially diagnose these colorectal adenomatous polyps is important for therapeutic intervention. To date, little efforts have been directed to identifying genetic changes involved in adenomatous polyps. This study was designed to examine the relevance of mitochondrial genome alterations in the three adenomatous polyps. Using high resolution restriction endonucleases and PCR-based sequencing, fifty-seven primary fresh frozen tissues of adenomatous polyps (37 tumors and 20 matched surrounding normal tissues) obtained from the southern regional Cooperative Human Tissue Network (CHTN) and Grady Memorial Hospital at Atlanta were screened with three mtDNA regional primer pairs that spanned 5.9 kbp. Results from our data analyses revealed the presence of forty-four variants in some of these mitochondrial genes that the primers spanned; COX I, II, III, ATP 6, 8, CYT b, ND 5, 6 and tRNAs. Based on the MITODAT database as a sequence reference, 25 of the 44 (57%) variants observed were unreported. Notably, a heteroplasmic variant C8515G/T in the MT-ATP 8 gene and a germline variant 8327delA in the tRNAlys was observed in all the tissue samples of the three adenomatous polyps in comparison to the referenced database sequence. A germline variant G9055A in the MT-ATP 6 gene had a frequency of 100% (17/17) in tubular and 57% (13/23) in villous adenomas; no corresponding variant was in tubulovillous adenomas. Furthermore, A9006G variant at MT-ATP 6 gene was observed at frequency of 57% (13/23) in villous adenomas only. Interestingly, variants A9006G and G9055A were absent in the villous tissue samples that were clinicopathological designated as "polyvillous adenomas". Our current data provide a basis for continued investigation of certain mtDNA variants as predictors of the three adenomatous polyps in a larger number of clinicopathological specimens.
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease. 1 It is among the fastest growing chronic diseases diagnosed in the world today. COPD is the third most common cause of death in the United States 2 and is predicted to get worse. It is characterized by the development of an exaggerated inflammatory response of the lungs to noxious substances such as tobacco or air pollution. If the exposure becomes recurrent or persistent, the lungs develop chronic inflammatory response leading to lung parenchymal damage, air trapping and progressive airflow limitation. The Diagnosis of COPD is usually made in the contest of symptoms, exposure to risk factors and spirometry evidence of airway obstruction with post bronchodilator spirometry FEV1/FVC < 0.70. Most patients with COPD first sick medical attention when they develop dyspnea. 1 Once the diagnosis of COPD has been confirmed, the treatment is geared mainly towards preventing exacerbations and eliminating risk factors and exposures. Several treatments combinations can be used in patients with stable COPD to prevent exacerbations and to improve their quality of life. Patients with COPD exacerbations have to be appropriately diagnosed and promptly treated to prevent complications. Patient's symptoms, the degree of airflow limitation, risk of exacerbations and the presence of comorbidities have to be assessed. Both pharmacological and non-pharmacological interventions have been used in the management of COPD.
Cocaine is a powerful central nervous system stimulant extracted from the leaves of Erythroxylon coca, a native plant of the Andean and Amazon regions in South America. Cocaine has multiple effects on the lungs, both acute and chronic. Effects of cocaine to the lungs depend on the route of administration (oral, nasal, intravenous), dose size, frequency of exposure, and presence of associated substances like heroin, talc or marijuana. These effects include barotrauma; airway injury; asthma; pulmonary edema; pulmonary hemorrhage; "crack lung", eosinophilic lung disease; bronchiolitis obliterans, organized pneumonia, interstitial lung disease; pulmonary hypertension; emphysema; both infectious and aspiration pneumonias; and tumors. The most commonly encountered respiratory symptoms include cough productive of dark sputum (carbonaceous material), chest pain, dyspnea, hemoptysis, wheezing, and exacerbation of asthma. Keywords:
Non-cardiac causes of elevated troponins are often overlooked, yet elevated troponins have been shown to closely correlate with the prognosis of these conditions. The clinical significance of elevated troponins in non-cardiac conditions are not completely known. Also, it is still unclear if these clinical conditions need to be managed differently when they lead to an increase in troponin levels. Some of the non-cardiac conditions in which elevated troponins are commonly found include: pulmonary embolism, end stage renal disease, Sepsis/ Systemic inflammatory response syndrome (SIRS) and critically ill patient, rhabdomyolysis, physical exercise, burns, drug toxicity and stroke. This article discusses the suggested etiology of elevated cardiac troponins in these conditions and the prognostic values they carry.
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