Endoscopy-assisted microsurgical total resection of craniopharyngioma in childhood.

Craniopharyngioma is a benign tumour that needs total resection to reduce the recurrence rate and consequently improve the quality of life for the affected children. As this tumour is closely related to the optic nerves, chiasm and hypothalamus, total removal cannot be achieved without difficulty. It has been reported that total resection could be achieved in up to 75% of the patients by microsurgical techniques. In this study we aimed to improve the total resection rate by adding endoscopy to the microsurgical instrumentation. This has improved the total resection rate by nearly 10%.     

Effect of concomitant use of pentoxifylline and alpha-tocopherol with radiotherapy on the clinical outcome of patients with stage IIIB non-small cell lung cancer

We evaluated the effects of pentoxifylline (PTX) and alpha-tocopherol on the clinical outcome of 66 patients with stage IIIB non-small cell lung cancer in a randomized clinical trial. All patients received 46 Gy of external radiotherapy to the primary tumor and regional lymph, nodes with an additional 14-Gy dose to the primary tumor. Thirty-three of the 66 patients also received PTX (400 mg, three times daily) and alpha-tocopherol (300 mg, twide daily) during radiotherapy, followed by 400 mg of PTX and 300 mg of alpha-tocopherol daily for 3 mo after radiotherapy. The remaining 33 patients (control group) received radiotherapy only. After a mean follow-up time of 12 mo, 18 patients remained alive. During follow-up, there were local recurrences in 14 patients and distant metastases in 18 patients. In patients who received PXT and alpha-tocopherol, 1- and 2-yr overall survival rates were 55% and 30%, respectively, and median survival was 18 mo. In control patients, 1- and 2-yr overall survival rates were 40% and 14%, respectively, with a median survival of 10 mo. These differences were statistically significant (p=0.0175). In patients who received PXT and alpha-tocopherol, progression-free survival rates for 1 and 2 yr were 48% and 23%, respectively; median survival was 12 mo. In the control group, the corresponding rates were 24% and 18%; median survival was 8 mo (p=0.0223). We conclude that the use of PTX and alpha-tocopherol combined with radiotherapy offers a possible survival advantage in this patient population.     

Study on the decomposition of 2-chloroethylnitro- sosulfamides (CENS) in serum using HPLC on-line solid phase extraction

In this paper we have investigated the kinetic decomposition of 2-chloroethylnitrososulfamides (CENS) in fetal calf serum. The study was monitored by on-line solid phase extraction linked to RP-LC-MS. We demonstrated that CENS are less stable in fetal calf serum than in aqueous buffer at pH 7.4 and 37 degrees C. Moreover, we have shown that partition coefficient of CENS can be correlated to the kinetics decomposition, and we observe that the stability is better for lipophilic CENS. The different metabolites after decomposition have been tentatively identified by RP-HPLC-MS. This study indicates the formation of several metabolites resulting from a mechanism of decomposition more complex than in aqueous phosphate buffer, nevertheless, leading to the same main products.     

Vaginal douching practice in Turkish women: who is douching, and why?

The aim of this study was to describe vaginal douching practices among women of reproductive age in Turkey, and to examine the association between this practice and adverse reproductive health consequences. Of the 524 participants, 58% reported vaginal douching at some time in their lives. The practice is primarily used for hygienic reasons and a majority used water alone and homemade solution. Using a multivariate model, only age (P = 0.05) and intrauterine device usage (P = 0.02) were associated with vaginal douching.     

Treatment of recurrent cerebellar hemangioblastoma with external radiotherapy in a patient with von Hippel-Lindau disease: a case report and review of the literature

Von Hippel-Lindau Disease, a multisystem familial cancer syndrome, is inherited as an autosomal-dominant trait. Common manifestations of the disease are retinal, cerebellar and medullary hemangioblastomas; renal cysts and carcinomas; pancreatic cysts; pheochromocytoma; and papilllary cystadenoma of the epididym. We report the case of a 40-year-old man with type I von Hippel-Lindau disease treated with external radiotherapy for recurrent cerebellar hemangioblastoma.     

Anterior abdominal wall synovial sarcoma: a rare presentation

Synovial sarcoma usually arises in the extremities and in close proximity to large joints. Primary synovial sarcoma of the anterior abdominal wall is rare. A 17-year-old girl was admitted to the hospital with a palpable abdominal mass, and there was a 9.5 cm x 7.5 cm x 6-cm lobulated, cystic, and semisolid lesion of in the external oblique abdominal muscle shown on the abdominal magnetic resonance image. She was then operated and pathology was consistent with synovial sarcoma. The presence of synovial sarcoma in extraarticular sites such as the abdominal wall argues against an origin from arthrogenous mesenchyme.     

Monoclonal antibody-based targeted therapy in breast cancer

Advances in molecular biology have identified tumor markers that not only predict prognosis and therapeutic response but may also function as potential therapeutic targets. Activated growth factor receptors induce breast cancer cells to proliferate, invade, and metastasize in experimental models. Overexpression of growth factor receptors has been associated with a poor clinical outcome in breast cancer patients. Biological therapy with monoclonal antibody directed against growth factor receptor pathways became important targeted therapy in breast cancer and is being pursued on various fronts. The anti-HER2 antibody trastuzumab is approved in the metastatic setting and is now trying to find the place in the adjuvant setting. Phase II and III studies with antibodies directed against VEGF and EGFR are also ongoing.