Purpose: The molecular pathogenesis of small intestinal adenocarcinomas is not well understood. Understanding the molecular characteristics of small bowel adenocarcinoma may lead to more effective patient treatment.Experimental Design: Forty-eight small bowel adenocarcinomas (33 non-celiac disease related and 15 celiac disease related) were characterized for chromosomal aberrations by high-resolution array comparative hybridization, microsatellite instability, and APC promoter methylation and mutation status. Findings were compared with clinicopathologic and survival data. Furthermore, molecular alterations were compared between celiac disease-related and non-celiac disease-related small bowel adenocarcinomas.Results: DNA copy number changes were observed in 77% small bowel adenocarcinomas. The most frequent DNA copy number changes found were gains on 5p15. 33-5p12, 7p22.3-7q11.21, 7q21.2-7q21.3, 7q22.1-7q34, 7q36.1, 7q36.3, 8q11.21-8q24.3, 9q34.11-9q34.3, 13q11-13q34, 16p13.3, 16p11.2, 19q13.2, and 20p13-20q13.33, and losses on 4p13-4q35.2, 5q15-5q21.1, and 21p11.2-21q22.11. Seven highly amplified regions were identified on 6p21.1, 7q21.1, 8p23.1, 11p13, 16p11.2, 17q12-q21.1, and 19q13.2. Celiac disease-related and non-celiac disease-related small bowel adenocarcinomas displayed similar chromosomal aberrations. Promoter hypermethylation of the APC gene was found in 48% non-celiac disease-related and 73% celiac disease-related small bowel adenocarcinomas. No nonsense mutations were found. Thirty-three percent of non-celiac disease-related small bowel adenocarcinomas showed microsatellite instability, whereas 67% of celiac disease-related small bowel adenocarcinomas were microsatellite unstable.Conclusions: Our study characterized chromosomal aberrations and amplifications involved in small bowel adenocarcinoma. At the chromosomal level, celiac disease-related and non-celiac disease-related small bowel adenocarcinomas did not differ. A defect in the mismatch repair pathways seems to be more common in celiac disease-related than in non-celiac disease-related small bowel adenocarcinomas. In contrast to colon and gastric cancers, no APC nonsense mutations were found in small bowel adenocarcinoma. However, APC promoter methylation seems to be a common event in celiac disease-related small bowel adenocarcinoma. Clin Cancer Res; 16(5); 1391-401. ©2010 AACR.

The effect of CCT and IOP as observed in the present study and by other studies in literature is less than predicted by both the Ehlers formula and the Orssengo and Pye model. Correcting IOP for the effect of CCT using these models could be erroneous and lead to overcorrection of IOP, thus resulting in erroneously low corrected IOP eyes with thicker cornea and erroneously high corrected IOP in eyes with thinner cornea.

Aims-This study investigated the eVect of peribulbar and retrobulbar local anaesthesia on intraocular pressure (IOP) and pulsatile ocular blood flow (POBF), as such anaesthetic techniques may adversely aVect these parameters. Methods-20 eyes of 20 patients who were to undergo phacoemulsification cataract surgery were prospectively randomised to receive peribulbar or retrobulbar anaesthesia. The OBF tonometer (OBF Labs, Wiltshire, UK) was used to simultaneously measure IOP and POBF before anaesthesia and 1 minute and 10 minutes after anaesthesia. Between group comparisons of age, baseline IOP, and baseline POBF were performed using the non-parametric Mann-Whitney test. Within group comparisons of IOP and POBF measured preanaesthesia and post-anaesthesia were performed using the non-parametric Wilcoxon signed ranks test for both groups. Results-There was no statistically significant IOP increase post-anaesthesia in either group. In the group receiving peribulbar anaesthesia, there was a significant reduction in POBF initially postanaesthesia which recovered after 10 minutes. In the group receiving retrobulbar anaesthesia, there was a persistent statistically significant reduction in POBF. Conclusions-Retrobulbar and peribulbar injections have little eVect on IOP. Ocular compression is not needed for IOP reduction when using local anaesthesia for cataract surgery. Conversely, POBF falls, at least for a short time, when anaesthesia for ophthalmic surgery is administered via a retrobulbar route or a peribulbar route. This reduction may be mediated by pharmacologically altered orbital vascular tone. It may be safer to use other anaesthetic techniques in patients with ocular vascular compromise. (Br J Ophthalmol 2001;85:796-798)

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Fundus biomicroscopy enables more accurate, less variable VCDR estimation than direct ophthalmoscopy. The clinician should record which method they used to examine the optic nerve head so that subsequent clinical decisions are not influenced by apparent VCDR changes.

If IOP measurements have to be repeated using the POBF Tonograph, they are best done after an interval of at least 2 minutes and preferably after 15 minutes. Use of the POBF Tonograph had no significant immediate effect on the IOP or POBF values obtained from a fellow eye.

PurposeTo identify relationships between central corneal thickness (CCT) and optic disc topography, as determined by scanning laser ophthalmoscopy (SLO), for patients seen in a specialist glaucoma service.Methods272 eyes of 144 patients with primary open angle glaucoma (POAG; n = 71), normal tension glaucoma (NTG; n = 50), ocular hypertension (OH; n = 48) and those considered to be suspicious for glaucoma (GS; n = 103) underwent ultrasonic pachymetry and optic disc topography by SLO. Correlations between CCT and SLO parameter values were identified. A Bonferroni correction for multiple comparisons was performed and a p value of <0.0042 was considered significant.ResultsMean CCT values were 533 μm (POAG), 530 μm (NTG), 550 μm (GS), and 565 μm (OH). As a group the GS and OH eyes had significantly thicker CCT values than eyes with POAG. In addition, the NTG eyes had significantly thinner CCT values than GS and OH eyes. Overall multiple SLO parameters correlated with CCT even after accounting for co-variance with age, refraction and inclusion of both eyes. Sub-group analysis indicated that ‘optic disc rim area’ positively correlated with CCT (r = 0.378) and ‘cup to disc area ratio’ negatively correlated with CCT (r = −0.370) in the POAG group. In the GS group the parameter ‘area below reference’ (a measure of cup volume) and ‘mean cup depth’ had negative correlations with CCT (r = −0.297 and −0.323) indicating that eyes with thinner than average corneal thickness measurements had larger and deeper cups.ConclusionThinner corneas appear to be associated with larger and deeper optic disc cups in the eyes of patients seen in a specialist glaucoma service.