Phase II trial of carboplatin and tegafur (Ftorafur) as induction therapy in squamous-cell carcinoma of the head and neck

Cisplatin and 5-fluorouracil by continuous infusion combination produces a high response rate in squamous-cell carcinoma of the head and neck (SCCHN). Carboplatin (CBDCA) is a cisplatin analogue with lower emetic potential and nephrotoxicity, although the myelosuppression potential is higher. Tegafur (ftorafur, FT) is an analogue of 5-fluorouracil. It is absorbed well in its oral form and has moderate gastrointestinal and hematologic toxicity. This clinical trial tested the association of CBDCA i.v. plus FT p.o. in patients with SCCHN who had not been previously treated. Twenty-one patients were evaluable for response; the overall response was 62% (33% complete response, 29% partial response). Toxicity was moderate in most of the patients, although there was a treatment-related death.     

Efficacy of antihypertensive treatment in the French population. A multicenter survey]

In order to assess the efficacy of antihypertensive treatment in the population, a study was undertaken in 5 French cities during the commercial fairs of Grenoble, Marseilles, Nice, Toulouse and Lille. The blood pressure was measured according to the WHO recommendations in volunteers. The study included a total of 7107 subjects of both sexes, with 4064 subjects in the 35-64 year age group. The therapeutic efficacy was evaluated in the 791 hypertensive patients who knew their antihypertensive therapy. Taking < 160/95 mmHg as the criterion of efficacy, 52 to 73% of the hypertensive patients were well controlled. However, if the therapeutic objective of normalisation of the blood pressure (BP < 140/90 mmHg) is taken as the criterion of efficacy, only 23 to 29% of the hypertensive patients were controlled whilst their BP remained significantly higher than that of normotensive controls of the same age. The difference in efficacy of antihypertensive therapy between the cities may be explained by the heterogenicity of the populations whereas the treatment did not differ significantly. After adjustment analysis with respect to sex showed that women were better controlled than men whatever the criterion chosen. The group controlled at BP < 160/95 mmHg only differed from the group < 140/90 with respect to the average BP value which was higher before treatment and decreased less with treatment; though this did not achieve statistical significance. In matters of public health, if the ideal blood pressure is taken as < 140/90 mmHg, this study shows that the objective is only attained in one out of four patients in the population studied.     

Tumor carcinoide de ovario asociado a un teratoma quístico maduro

Primary ovarian carcinoid tumors are uncommon neoplasias, less than 0.1% of all ovarian cancer They should be treated like ovarian tumors of low malignity. We present a case associated with mature cystic teratoma in a patient of 88 year old with history of diarrhea and had loss of weight     

Correlation among Thermosensitive Period, Estradiol Response, and Gonad Differentiation in the Sea TurtleLepidochelys olivacea

Reptile embryos with temperature sex determination have a thermosensitive period (TSP). The finding that exogenous estradiol (E2) overcomes the effect of male-promoting temperature led to the idea that temperature may regulate estrogen concentration in the gonad during TSP. Since interspecific variations in TSP and in the effect of exogenous E2 exist, we undertook a study in the olive ridleyLepidochelys olivacea.Four parameters were correlated: the TSP (time dimension), the thermosensitive stages (rate of development), gonad development (histological aspect), and the estradiol response. Two kinds of experiments were performed: (1) Eggs were shifted once, at different stages of development, from a male-promoting temperature to a female-temperature (or vice versa) for the remainder of development. (2) Eggs at male-promoting temperature were treated once with 6 or 12 μg of estradiol (E2) at various times of incubation. Sex ratio was established around hatching in each experimental series. We found that the temporal dimension of the TSP was around 7 days (Days 20–27 of incubation) at a male-promoting or a female-promoting temperature. The rate of development of the whole embryo and gonadal growth was faster at female-promoting temperature than at male-promoting temperature. Formation of the genital ridge began at stage 21–22 and histological differentiation of the gonads occurred around stage 26–27. Although these stages coincided with the TSP, at male-promoting temperature the thermosensitive stages occurred earlier (from stages 20–21 to stages 23–24) than at female-promoting temperature (from stages 23–24 to stages 26–27). Thus, at male promoting-temperature, sex was determined in embryos with incipient or undifferentiated gonads. In contrast, E2 treatment continued to feminize the gonads of embryos at a male-promoting temperature beyond the TSP up to stage 25–26, but the E2-induced ovaries were significantly smaller than temperature-induced ovaries. It is suggested that the doses of E2 used were higher than the concentration of endogenous E2 required for normal sex determination. The lack of correlation between sex determination and gonad differentiation suggests that irreversible molecular processes underlying sex determination occur earlier at male- than at female-promoting temperature. Results suggest that the male sex may be the default state and that the female condition must be imposed upon it.     

Human and rat macrophages mediate fungistatic activity against Rhizopus species differently: in vitro and ex vivo studies.

Both rat alveolar macrophages and a human macrophages cell line with characteristics of human tissue (e.g., alveolar) macrophages (THP-1) were found to inhibit the germination of Rhizopus spores. However, the conditions under which fungistatic activity occurs are different for these two cell types. The inhibition of Rhizopus spore germination by rat alveolar macrophages requires the activation of macrophages and the presence of serum and L-arginine. During rat alveolar macrophage-mediated fungistatic activity, L-arginine is oxidized to nitric. Human macrophage-mediated fungistatic activity is similar to that mediated by rat macrophages in terms of the serum requirement, but it does not require L-arginine. Human macrophages did not produce any nitrite detectable by the colorimetric assay. Their ability to inhibit germination was enhanced by the combination of endotoxin and gamma interferon. The inhibition of Rhizopus spore germination by rat alveolar macrophages is thus mediated by the generation of nitric oxide, whereas the mechanism of similar inhibition by human macrophages remains poorly understood. Serum samples from diabetic rats as well as from patients with diabetes or uremia decreased the inhibitory effect of macrophages on spore germination. Dialysis of the serum samples against a buffered salt solution antagonized this phenomenon, indicating that a low-molecular-weight factor in the sera of patients with diabetes or uremia may modulate local antifungal defense mechanisms. The absence of L-arginine-dependent nitrogen oxidation in human macrophages, compared with its presence in rat alveolar macrophages, under conditions during which fungistatic activity occurs suggests that this phenomenon is species specific.     

Intraepithelial Lymphocyte Cytometric Pattern Is a Useful Diagnostic Tool for Coeliac Disease Diagnosis Irrespective of Degree of Mucosal Damage and Age—A Validation Cohort

Introduction: The study of intraepithelial lymphocytes (IEL) by flow cytometry is a useful tool in the diagnosis of coeliac disease (CD). Previous data showed that an increase in %TCRγδ⁺ and decrease of %CD3⁻ IEL constitute a typical CD cytometric pattern with a specificity of 100%. However, there are no data regarding whether there are differences in the %TCRγδ⁺ related to sex, age, titers of serology, and degree of histological lesion. Study aims: To confirm the high diagnostic accuracy of the coeliac cytometric patterns. To determine if there are differences between sex, age, serology titers, and histological lesion grade. Results: We selected all patients who fulfilled “4 of 5” rule for CD diagnosis (n = 169). There were no differences in %TCRγδ⁺ between sexes (p = 0.909), age groups (p = 0.986), serology titers (p = 0.53) and histological lesion grades (p = 0.41). The diagnostic accuracy of complete CD cytometric pattern was: specificity 100%, sensitivity 82%, PPV 100%, NPV 47%. Conclusion: We confirmed, in a validation cohort, the high diagnostic accuracy of complete CD pattern irrespective of sex, age, serology titers, and grade of mucosal lesion.