BACKGROUND: Thiopurine S-methyltransferase (TPMT) is a cytosolic enzyme that catalyzes the S-methylation of 6-mercaptopurine and azathioprine. Low-activity phenotypes are correlated with polymorphism in the TPMT gene. Patients with low or undetectable TMPT activity could develop severe myelosuppression when they are treated with standard doses of thiopurine drugs. Since ethnic differences in the TPMT gen polymorphism have been demonstrated worldwide, its assessment in the Chilean population is worthwhile. AIM: To investigate the TMPT gene polymorphism in a Chilean blood donor individuals. SUBJECTS AND METHODS: The frequency of four allelic variants of the TPMT gene,*2 (G238C),*3A (G460A and A719G),*3B (G460A) and *3C (A719G) were analyzed in 210 Chilean blood donors, using polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP) and allele-specific PCR-based assays. RESULTS: TPMT variants associated to low enzymatic activity, were detected in 16 subjects (8%), who had a heterozygous genotype (*3A in 12;*3C in three and *2 in one subject). No TPMT*3B allelic variant was found. The normal allele (wild-type) was found in 92% of studied individuals. CONCLUSIONS: The allele TPMT*3A, is the most prevalent in this group of Chilean blood donors, as in Caucasian populations.

We report the case of an infant 3 months old with a rare association, tetralogy of Fallot with total anomalous pulmonary veins connection the diagnosis was made by echocardiography and a successful complete reparation was achieved.

BACKGROUND: Interest in natural orifice transluminal endoscopic surgery (NOTES) has expanded, and the first experiences with patients using different techniques have been reported. However, no work has addressed the learning process or the limitations of the procedures. The relation between inexperience and complications became a major concern after the introduction of laparoscopic surgery. This study investigates the learning process for a new technique using specially designed instruments in an ex vivo model before clinical application. METHODS: Specially designed instruments and a single-port technique using the Tuebingen Trainer were used to evaluate instrument and surgeon performance (learning curve) in terms of time and errors. A total of 90 procedures performed by three surgeons were evaluated. Group and individual learning curves were plotted. RESULTS: All the surgeons showed a reduction in both mean cholecystectomy time (subject A: 27.2 vs 16.6 min; subject B: 21.4 vs 19.22 min; subject C: 21 vs 19.7 min) and mean errors (subject A: 2.8 vs 1.6; subject B: 3.5 vs 2.6; subject C: 3.5 vs 2). A plateau was reached after approximately 15 procedures. Group learning curve analysis showed a significant reduction in time between the first group (mean, 24.97 +/- 5.8 min) and last group (mean, 19.30 +/- 3.09 min; F[1,28]= 11.83; p = 0.001) for 15 procedures, as well as reduced technical errors in the fifth group, from 3.7 +/- 1.65 to 1.6 +/- 1.04 (F[1,28]= 8.90; p < 0.01), demonstrating a learning effect. The number of optic and access port position changes were recorded, setting a standard for normal instrument performance. CONCLUSION: This study shows that the tasks of cholecystectomy can be learned safely in a reasonable number of simulations with the new instruments. Although this is a new technique, prior laparoscopic surgery experience is helpful. The technique offers an advantage over those using flexible endoscopes.

BACKGROUND: The Radius Surgical System (RSS) is a manipulator with additional degrees of freedom to enhance the dexterity of laparoscopic suturing. Our aim was to determine the feasibility and potentially added value of laparoscopic intracorporal sutured colorectal anastomosis (RSS) compared with suturing with conventional laparoscopic instruments (CLI). METHODS: A total of 72 colorectal anastomoses and 30 single sutures using RSS and CLI were performed in the study. The experiment was divided as follows: One surgeon performed 40 colorectal anastomoses using RSS to assess the learning curve and the feasibility of the technique; The same surgeon performed 10 additional colorectal anastomoses with CLI which were then compared to the last 10 cases of the 40 anastomoses with RSS; Fifteen single sutures in the horizontal plane with RSS and 15 with CLI between two segments of colon were performed to compare the traction force to disrupt the suture; Twelve anastomoses were performed by the other three participants to evaluate ergonomy. RESULTS: Three leakages (7.5%) were found in the 40 anastomoses with RSS but none after the eighth case. There was no stenosis. The mean time for the anastomoses once the learning curve was achieved was 32.7 min. After 21 anastomoses with RSS there was no improvement in the operating time. The quality of the suture was superior with RSS, with a larger anastomosis diameter, higher bursting pressure, and fewer suturing failures being found. The RSS suture withstood a higher traction force. The participants showed more discomfort suturing with CLI. CONCLUSION: This study demonstrated the feasibility of laparoscopic colorectal anastomosis using RSS. Anastomosis with RSS was shown to be safer. The three participants evaluating ergonomy reflected less discomfort in hand/wrist using RSS. Others ergonomic problems were comparable to CLI.

OBJECTIVE: To describe the anesthetic technique used, the evaluation of airway patency, and the perioperative complications in patients with lower than average intelligence (mentally disabled) who are administered general anesthesia for dental surgery. MATERIAL AND METHODS: We carried out a prospective, descriptive, comparative study of mentally disabled ASA 2-3 patients. The patients were distributed in 2 groups: mild to moderate mental disability and severe to very severe mental disability. Induction was via intravenous or inhaled anesthesia depending on availability of venous access. Maintenance was with sevoflurane in oxygen and air at variable concentrations in order to maintain a bispectral index (BIS) between 40 and 60. Statistical comparisons were based on the chi2 test, the log-rank test and the t test. RESULTS: Forty-seven patients were enrolled. The anesthetic technique maintained hemodynamic stability in both groups. No statistically significant differences were found in Mallampati classification, Cormack-Lehane classification, or level of disability. The incidence of complications was higher in the group with more severe disability; the most common complication was difficult tracheal intubation. Bradycardia was the most common complication in the group with mild to moderate mental disability. CONCLUSIONS: The anesthetic technique used in this study proved to be safe and effective in this type of patient. A higher degree of mental disability led to less effective examination of the airway and more difficult direct laryngoscopy. BIS was as effective for monitoring in this population as it is in the general population.

Fusarium oxysporum f. sp. vasinfectum (Fov) has the potential to become the most economically significant pathogen of cotton in Australia. Although the levels of resistance present in the new commercial cultivars have improved significantly, they are still not immune and cotton breeders continue to look for additional sources of resistance. The native Australian Gossypium species represent an alternative source of resistance because they could have co-evolved with the indigenous Fov pathogens. Forty-six BC(3 ) G. hirsutum x G. sturtianum multiple alien-chromosome-addition-line (MACAL) families were challenged with a field-derived Fov isolate (VCG-01111). The G. hirsutum parent of the hexaploid MACAL is highly susceptible to fusarium wilt; the G. sturtianum parent is strongly resistant. Twenty-two of the BC(3) families showed enhanced fusarium wilt resistance relative to the susceptible G. hirsutum parent. Logistic regression identified four G. sturtianum linkage groups with a significant effect on fusarium wilt resistance: two linkage groups were associated with improved fusarium wilt resistance, while two linkage groups were associated with increased fusarium wilt susceptibility.

The Australian diploid Gossypium species possess traits of potential agronomical value, such as gossypol-free seeds and Fusarium wilt resistance. However, they belong to the tertiary germplasm pool, which is the most difficult group of species from which to introgress genes into G. barbadense L. and G. hirsutum L. Interspecific triploid hybrids can be generated but they are sterile. The sterility barrier can be overcome using synthetic polyploids as introgression bridges, but whether there is sufficient homoeologous chromosome interaction at meiosis to allow recombination is still an open question. To ascertain, genetically, observable levels of homoeologous introgression, 2 synthetic hexaploid lines (2x G. hirsutum x G. australe and 2x G. hirsutum x G. sturtianum) were crossed to G. hirsutum to generate pentaploid F1 plants that, in turn, were backcrossed to G. hirsutum to generate BC1 and BC2 multiple alien chromosome addition lines (MACALs). Gossypium australe F. Muell. and G. sturtianum Willis chromosome-specific markers were used to track the frequency and fidelity of chromosome transmission to the BC1 and BC2 MACALs. The chromosomal location of the AFLP markers was determined by their distribution among the MACALs and confirmed in parental F2 families. Roughly half the available chromosomes were transmitted to the G. hirsutum x G. australe (54%) and G. hirsutum x G. sturtianum (52%) BC1 MACALs. The BC2 MACAL families again inherited about half of the available chromosomes. There were, however, notable exceptions for specific chromosomes. Some chromosomes were preferentially eliminated, while others were preferentially transmitted. Consistent with the genomic stability of Gossypium synthetic polyploids, the de novo loss or gain of AFLP fragments was rarely observed. While restructuring of the donor G. australe and G. sturtianum chromosomes was observed, this is more likely the result of chromatin loss, and no clear cases of introgression of donor chromatin into the recipient G. hirsutum genome were observed.