Heritable methylation marks associated with prostate cancer risk

DNA methylation marks that are inherited from parents to offspring are known to play a role in cancer risk and could explain part of the familial risk for cancer. We therefore conducted a genome-wide search for heritable methylation marks associated with prostate cancer risk. Peripheral blood DNA methylation was measured for 133 of the 469 members of 25 multiple-case prostate cancer families, using the EPIC array. We used these families to systematically search the genome for methylation marks with Mendelian patterns of inheritance, then we tested the 1,000 most heritable marks for association with prostate cancer risk. After correcting for multiple testing, 41 heritable methylation marks were associated with prostate cancer risk. Separate analyses, based on 869 incident cases and 869 controls from a prospective cohort study, showed that 9 of these marks near the metastable epiallele VTRNA2-1 were also nominally associated with aggressive prostate cancer risk in the population.

Repeatability of methylation measures using a QIAseq targeted methyl panel and comparison with the Illumina HumanMethylation450 assay

OBJECTIVE

In previous studies using Illumina Infinium methylation arrays, we have identified DNA methylation marks associated with cancer predisposition and progression. In the present study, we have sought to find appropriate technology to both technically validate our data and expand our understanding of DNA methylation in these genomic regions. Here, we aimed to assess the repeatability of methylation measures made using QIAseq targeted methyl panel and to compare them with those obtained from the Illumina HumanMethylation450 (HM450K) assay. We included in the analysis high molecular weight DNA extracted from whole blood (WB) and DNA extracted from formalin-fixed paraffin-embedded tissues (FFPE).

RESULTS

The repeatability of QIAseq-methylation measures was assessed at 40 CpGs, using the Intraclass Correlation Coefficient (ICC). The mean ICCs and 95% confidence intervals (CI) were 0.72 (0.62-0.81), 0.59 (0.47-0.71) and 0.80 (0.73-0.88) for WB, FFPE and both sample types combined, respectively. For technical replicates measured using QIAseq and HM450K, the mean ICCs (95% CI) were 0.53 (0.39-0.68), 0.43 (0.31-0.56) and 0.70 (0.59-0.80), respectively. Bland-Altman plots indicated good agreement between QIAseq and HM450K measurements. These results demonstrate that the QIAseq targeted methyl panel produces reliable and reproducible methylation measurements across the 40 CpGs that were examined.

Evaluation of orchidopexy with or without opening the external oblique fascia in children with superficial inguinal undescended testis

INTRODUCTION

Orchidopexy is one of the most common pediatric surgeries. In general, the operation for truly undescended testis (UDT) includes opening of the external oblique fascia. The most common location of the testis in UDT is adjacent to the external inguinal canal (superficial inguinal type). Using a new method we performed orchidopexy without opening the fascia. In this clinical trial we compared the outcome after a classic procedure with that obtained using our method.

METHODS AND PATIENTS

This clinical controlled trial was undertaken in the Al Zahra hospital between 2008 and 2010. Patients were randomized into either into the closed technique group (group A, n=52) or the open group (group B, n=52). The incidence of short-term and long-term complications was recorded with a specific questionnaire at the time of surgery and at follow-up visits. Data were analyzed with the SPSS 15.0 software using chi-square and t-tests.

RESULTS

104 patients were included in this study. The incidence of short-term complications (surgical site hematoma, surgical wound infection, scrotal hematoma) and long-term complications (testicular atrophy) did not differ significantly between the 2 groups. Procedure duration in group A was significantly shorter than in group B (p=0.001). Medial thigh sensory loss was more common in group B (p=0.05).

CONCLUSION

When investigating the surgical management of undescended testes, our study found differences in medial thigh sensory loss rate and procedure duration between the open and closed techniques. Operative treatment of UDT without opening the external oblique fascia is highly recommended.

Use of a preoperative playroom to prepare children for surgery

OBJECTIVE

The aim of this study was to evaluate the efficacy of a playroom next to the operating room to reduce preoperative anxiety in children.

METHODS AND MATERIALS

In 2009, we designed a playroom in a preoperative waiting room in our hospital. The playroom had colored toys and cars appropriate for different ages and a TV and video to show cartoons. Patients were randomly assigned into a case or a control group. Control group patients were admitted to the preoperative waiting room 30 min prior to operation. Case group patients were admitted to the playroom for the same period of time. The anxiety levels of the children were compared using the modified Yale Preoperative Anxiety Scale (m-YPAS).

RESULTS

In this study 200 children were evaluated (100 patients in the case group, 100 patients in the control group). There were 20 female and 80 male patients in the case group with a mean age of 4.33 ± 1.5 years and 26 female and 74 male patients in the control group with a mean age of 3.87 ± 1.2 years (p=NS). Inguinal herniorraphy was the most common procedure in both groups. Preoperative anxiety was significantly decreased for all categories of the anxiety score as assessed by m-YPAS questionnaire.

CONCLUSION

A preoperative playroom is a very effective method to reduce preoperative anxiety in children.

Perineal mesh rectopexy with sterile talc in children with rectal prolapse

BACKGROUND

With such a wide variety of treatment options available for rectal prolapse and a variable success rate, the optimal treatment for this condition in children is still debated. In this study, we evaluated a technique of perineal mesh rectopexy with a sterile talc-soaked mesh and compared the success rates and complications of this method with those of abdominal rectopexy.

METHODS AND MATERIALS

To examine the effect of therapeutic interventions, a randomized control trial (children were randomized into the case group or the control group) was carried out. In the control group, children were operated on by abdominal posterior mesh rectopexy. In the case group, a 30-cm sterile asbestos-free talc-soaked mesh was placed in the presacral space in a spiral fashion with the end exiting from the perineal incision. From 5 (th) day after surgery onward, the mesh was gradually extracted (10 cm per day) and completely removed by the 7 (th) postoperative day. On postoperative assessment, the duration of hospitalization, the postoperative complications and the success rates after surgery were compared. Patients were followed up for one year.

RESULTS

In this study we evaluated 120 children. Mean age of the patients was 5.1±0.081 years in the case group and 4.91±0.59 years in the control group (p=NS). 34 patients in the case group were male vs. 41 patients in the control group. Results indicated that there was no statistically significant difference in postoperative complications between groups. The infection rate was 1.6% in the case group and 6.6% in the control group (p=NS).There was a higher resolution of constipation in the perineal rectopexy group (68.4% in the control group and 96.8% in the case group; p=0.002). The duration of hospitalization was 6.34±0.28 days in the case group and 6.68±0.31 days in the control group (p=NS).

CONCLUSION

Our findings suggest that perineal mesh rectopexy with sterile talc can be an alternative approach to abdominal surgery and offers an acceptable outcome with a low rate of complications.