Mucosal melanoma of the cranio-facial region: Surgical challenges and therapeutic options

Objective

Although current therapeutic options for cutaneous melanoma (CM) are constantly improving survival, mucosal melanoma (MM) remains a rare tumor disease with a poor clinical outcome. While radical surgery is the gold standard, clear margin resections in the head and neck area are particularly critical due to high density of vulnerable structures. Adjuvant therapeutic options increases local control and data on the effect of systemic agents is sparse. The aim of this study was to elucidate surgical challenges in the craniofacial area and to evaluate the effect of local and systemic therapy in Head and Neck Mucosal Melanoma (HNMM).

Determination of the spatial orientation and shape of pulmonary vein ostia by contrast-enhanced magnetic resonance angiography.

AIMS: For catheter ablation of atrial fibrillation (AF), proper catheter positioning is crucial and depends on knowledge of pulmonary vein (PV) anatomy. The aim of this study was to assess PV spatial orientation and ostial shape by contrast-enhanced magnetic resonance angiography (CE-MRA). METHODS AND RESULTS: In 30 consecutive AF patients, CE-MRA was performed prior to ostial ablation. Using a centre-line technique, the PV ostium was defined perpendicular to this centre-line. Minimal and maximal ostial diameters, ostial perimeter, and angles in the anatomical frontal and transverse planes were measured. Twenty-one patients had four separate PVs. In four patients, there was a distinct right-middle PV and in five a common left common PV was found. Left-sided PV ostia were smaller and more elliptical than right-sided PVs. In the transverse plane, the ostia of both superior PVs were directed anteriorly (LS -15 +/- 13 degrees , RS -13 +/- 11 degrees ) and both inferior PV ostia were directed posteriorly (LI 23 +/- 15 degrees , RI 39 +/- 15 degrees ). In the frontal plane, both superior PV ostia pointed upwards (LS -27 +/- 14 degrees , RS -33 +/- 12 degrees ) while the inferior ostia were directed horizontally (LI 2 +/- 11 degrees , RI 3 +/- 13 degrees ). CONCLUSION: PV ostial shape and spatial orientation are variable and can be visualized adequately by CE-MRA.     

Loss and gain of chromosomes 1, 18, and Y in prostate cancer

Nuclear suspensions of 42 prostate carcinoma specimens obtained at surgery were used to investigate loss and gain of chromosomes 1, 18, and Y by fluorescence in situ hybridization (FISH) with centromere-specific probes. The outcome of FISH analysis was correlated with clinical parameters and the relationship between DNA-FCM (ploidy at cellular level) and FISH (ploidy of individual chromosomes) was assessed. Significant loss of chromosomes 1 and 18 was infrequent (respectively, three and five cases), but 53% of the tested specimens showed loss of Y. Loss was not correlated with DNA ploidy. Significant gain occurred in 36% (chromosome 1), 63% (chromosome 18), and 28% (Y) of the specimens. Gain of chromosome 18 was shown in DNA diploid (7/14) and aneuploid tumors (18/26), while gain of chromosomes 1 and Y was nearly restricted to DNA aneuploid specimens. Significant unbalance between these chromosomes occurred in 11 cases. Most cases which had significant gain of chromosome 1 or 18 showed trisomic as well as tetrasomic cells. Simultaneous loss of some and gain of other investigated chromosomes is suggestive of clonal heterogeneity and/or multiclonality. This was observed in eight tumors. Correlation between DNA-FCM and FISH was best for the Y chromosome. DNA-FCM showed more aberrant histograms with increasing stage and grade of tumors. The presence of numerical aberrations of the investigated chromosomes however, seemed independent of clinical grade or stage. © 1994 Wiley-Liss, Inc.     

Enhancement of the bacterial degradation of phenoxyalkanoate herbicides by the use of modified polyurethane foam as a support

The enhancement of the degradative behaviour of Flavobacterium sp. MH concerning the phenoxyalkanoate herbicides 2,4-D, 2,4-DP, 2,4-DB, MCPA, MCPP, and MCPB, respectively, was achieved by the use of an inert polyurethane (PU)-foam. In comparative batch-degradation experiments with and without the addition of the PU-carrier (1.25 % w/v), respectively, the advantages of the PU-supply were demonstrated. When 2,4-D, 2,4-DP, and MCPP, respectively, was used as a growth substrate by strain MH the PU-supply led to a reduced lag-phase. In the case of the stronger toxic phenoxyalkanoates 2,4-DB and MCPB, respectively, the inital substrate concentration (0.1 g/1) was significantly reduced to a minor toxic concentration due to a distinct adsorption to the PU-carrier, thus enabling the biodegradation. Finally, the total initially supplied amount of the phenoxyalkanoates was detoxified as verified by thechloride balance. After several steps of subcultivation, even a five-fold increased MCPB concentration (0.5 g/1) could be detoxified by strain MH in a PU-supplied bubble reactor within several days.     

Changes in the classification of carcinogenic chemicals in the work area

Carcinogenic chemicals in the work area are currently classified into three categories in section III of the German List of MAK and BAT Values (list of values on maximum workplace concentrations and biological tolerance for occupational exposures). This classification is based on qualitative criteria and reflects essentially the weight of evidence available for judging the carcinogenic potential of the chemicals. It is proposed that these categories – IIIA1, IIIA2, IIIB – be retained as Categories 1, 2, and 3, to correspond with European Union regulations. On the basis of our advancing knowledge of reaction mechanisms and the potency of carcinogens, these three categories are supplemented with two additional categories. The essential feature of substances classified in the new categories is that exposure to these chemicals does not contribute significantly to risk of cancer to man, provided that an appropriate exposure limit (MAK value) is observed. Chemicals known to act typically by nongenotoxic mechanisms and for which information is available that allows evaluation of the effects of low-dose exposures, are classified in Category 4. Genotoxic chemicals for which low carcinogenic potency can be expected on the basis of dose-response relationships and toxicokinetics, and for which risk at low doses can be assessed are classified in Category 5. The basis for a better differentiation of carcinogens is discussed, the new categories are defined, and possible criteria for classification are described. Examples for Category 4 (1,4-dioxane) and Category 5 (styrene) are presented.     

Potential adrenal gland imaging agents. II: Radioiodination of p-hydroxyphenyl derivatives of digitoxigenin, dihydrodigitoxigenin and scillarenin

Potential Adrenal Gland Imaging Agents. II: Radioiodination of p-Hydroxyphenyl Derivatives of Digitoxigenin, Dihydrodigitoxigenin and Scillarenin As potential adrenal gland imaging agents the p-hydroxyphenyl derivatives of the aglycones digitoxigenin (1) , dihydrodigitoxigenin (2) and scillarenin (3) are synthetized and radioiodinated. The aglycones are dehydrogenated to the corresponding ketones and reacted regioselectively with 2-(4-lithiophenoxy)tetrahydropyran (18) to yield 7-9 . The protecting group is removed under mild conditions and 3-(p-hydroxyphenyl)-3-hydroxydigitoxigenin (10), 3-(p-hydroxyphenyl)-3-hydroxydihydrodigitoxigenin (11) and 3-(p-hydroxyphenyl)-3-hydroxyscillarenin (12) are obtained. The insertion of the p-hydroxyphenyl group allows the aglycone derivatives to be radioiodinated rapidly. An activity of 10 to 41 mCi per mg starting material is obtained with carrier-free ¹³¹I.