External-beam irradiation of carcinoma of the penis

Twenty-four patients with biopsy-proved squamous-cell carcinoma of the penis underwent external-beam radiation therapy between 1966 and 1980. Fifteen were treated for the primary tumor and 9 for metastatic inguinal lymphadenopathy; no patient received prophylactic nodal irradiation. Doses ranged from 4,500 rad (45 Gy)/15 fractions/3 wk. to 6,400 rad (64 Gy)/32 fractions/6 1/2 wk. Seven out of 9 tumors in stage I, 2/3 in stage II, and 1/3 in stage IV were controlled for three years. Control of fixed, inoperable groin nodes was poor, and none of these patients survived beyond 1 1/2 years.     

Paternity testing with an absent mother. The probability of exclusion of red cell surface antigen, Gm, Hp, and HLA systems in North American whites and blacks

Blood tests in cases of disputed paternity can be extremely useful even when the mother's blood sample is not available. The mean probability of exclusion (A) of red cell surface antigen, Gm, Hp, and HLA systems was determined in this situation for North American whites and blacks by creating pairs of a man and an unrelated child. In whites, the most valuable of the systems investigated to indicate nonpaternity for false fathers were HLA, Rh, Fy, and MNSs, in that order. HLA, MNSs, and Gm were the most valuable systems in blacks. With all of the genetic systems used in this study, the combined probability of exclusion (CPE) of men falsely accused of paternity, in cases where the mother is absent, is approximately 95 percent for whites and 92 percent for blacks. Since only indirect exclusions are possible without the mother, the common test panel of HLA and red cell antigens may not always allow an adequate study. Extended testing is recommended to include additional genetic systems in order to achieve an average combined probability of exclusion of at least 95 percent.     

The rationale of acid suppression in the treatment of acid-related disease.

Acid-related disorders such as gastric and duodenal ulcers and gastro- oesophageal reflux disease have a high prevalence. Traditionally, acid suppression has proved to be the most effective means by which to heal these disorders, but relapse rates are high after cessation of treatment. Recently, Helicobacter pylori infection has been shown to modify several aspects of gastric function. Eradication of H. pylori infection virtually abolishes duodenal ulcer recurrence, implicating this organism in the pathogenesis of peptic ulcers and initiating a whole new strategy in the management of these acid-related disorders. More potent degrees of acid suppression result in faster healing. Moderate acid suppression, as occurs with H2-receptor antagonists, can heal just as many ulcers if treatment is continued for longer. The combination of proton pump inhibitors and antibiotics have successfully eradicated H. pylori in duodenal ulcer patients. Both H2-receptor antagonists and the proton pump inhibitors have satisfactory safety profiles. Due to their superiority in symptom relief, and in the healing of duodenal and gastric ulcers and erosive oesophagitis, and due to their ability to eradicate H. pylori infection in combination with antibiotics, the proton pump inhibitors will probably become accepted as first-line therapy for the treatment of acid-related diseases.     

Desmoplastic fibroma of bone: radiographic analysis

Desmoplastic fibroma (DF) of bone is a rare, nonmetastasizing but locally aggressive tumor that has been discussed infrequently in the radiology literature. The radiographs from 107 previously published cases of DF and seven cases from the authors' institution were analyzed to better understand and define its radiographic characteristics. DF was most common in the mandible, pelvis, and femur. A geographic pattern of bone destruction, with a narrow zone of transition and nonsclerotic margins, was seen in 80 (96%) patients with intraosseous DF for whom radiographs were available (83 patients). Internal pseudotrabeculation was seen in 76 (91%). Although widening of the host bone due to gradual apposition of periosteal new bone was common, occurring in 74 (89%) patients, distinct periosteal new bone occurred in only two (2%) patients with DF of intraosseous origin. The cortex was breached in 23 (28%) patients. Three cases of DF arising in the periosteum were identified and were differentiated radiographically from desmoid tumors of intraosseous or soft-tissue origin.