Immunohistochemical detection of cervical lymph node micrometastases from T2N0 tongue cancer

CONCLUSIONS: These results indicate that extensive, multiple cervical micrometastases occurred from an early stage in patients with T2N0 tongue cancer. The presence of micrometastases suggests the necessity of preventive neck dissection for Level I-IV nodes as a radical treatment. OBJECTIVE: Cervical lymph node metastases occur with a relatively high frequency in patients with T2N0 squamous cell carcinoma of the tongue, and control of the metastases greatly influences the prognosis of patients. In this study, micrometastases in the cervical lymph nodes were investigated to clarify the necessity and required extent of preventive neck dissection. MATERIAL AND METHODS: We investigated micrometastases in 24 subjects who had previously been diagnosed with T2N0 tongue cancer. We performed immunostaining with anti-cytokeratin antibody cocktail AE1/AE3 of sections of 401 paraffin-embedded lymph nodes obtained from these patients. RESULTS: Micrometastases were observed in 14 patients (58%) and were most abundant in Level II nodes (n=11; 46%). Micrometastases were observed in the Level IV nodes of 3 patients (13%), and upstaging to pN2b occurred in 7 patients (29%).     

Epitope definition by proteomic similarity analysis: identification of the linear determinant of the anti-Dsg3 MAb 5H10

Background  

Walking along disease-associated protein sequences in the search for specific segments able to induce cellular immune response may direct clinical research towards effective peptide-based vaccines. To this aim, we are studying the targets of the immune response in autoimmune diseases by applying the principle of non-self-discrimination as a driving concept in the identification of the autoimmunogenic peptide sequences.     

Band-pass specific contributions of multiple generators to the auditory 40-Hz steady state potentials

OBJECTIVE: The purpose of this study was to separate the composite components of the auditory 40 Hz steady-state potentials (40 Hz SSP), by differentially augmenting them with filtering at different low passes, and to compare them with their counterparts in the transient-evoked auditory middle-latency evoked potentials (AMEP). METHODS: Transient-evoked AMEP to 3.3/sec clicks and 40 Hz SSP to 40/sec clicks were recorded from 18 subjects using three orthogonally positioned electrode pairs. Each type of potentials was filtered with a 100 Hz and with a 50 Hz low pass. Equivalent dipoles of components were estimated using Three-channel Lissajous' Trajectories and compared between filter settings (50 and 100 Hz low pass) and between the transient-evoked and the steady-state potentials. RESULTS: With a band pass of 3 to 100 each period of the 40 Hz SSP consisted of a brain stem (V) and four cortical (P0 Na, Pa1 Pa2, and Nb) components. The lower-frequency components of the 40-Hz response corresponded in latency and equivalent dipole orientation to the later transient-evoked cortical AMEP components, whereas the higher-frequency components corresponded to the earlier, brain stem and primary cortical components of transient-evoked AMEP. Band-pass filtering at 3 to 50 Hz resulted in fewer components, as early brain stem and primary cortical components diminished. CONCLUSIONS: A band pass of 3 to 100 Hz for recording the 40 Hz SSP results in a composite waveform comprising of distinct brain stem and cortical generators with different orientations of their equivalent dipoles. The relative contributions of the multiple constituents are affected by the acquisition filter low pass: brain stem and primary cortical generators mostly contribute the high frequencies and later cortical contributions dominate the lower frequencies.     

Usefulness of Ureteropyeloscopy for diagnosis of upper urinary tract tumors

BACKGROUND: Upper urinary tract tumors have historically been diagnosed using urinary cytology examination and radiography. As the technique and instrumentation of ureteroscopic inspection and biopsy have advanced, ureteroscopic examination has become more routine. We studied the applicability and safety of using ureteropyeloscopy to diagnose upper urinary tract tumors. PATIENTS AND METHODS: Between January 1994 and October 1999, 50 patients at Kobe University Hospital underwent ureteropyeloscopy for suspected upper urinary tract tumors. RESULTS: The sensitivity values of radiography, urinary cytology, and ureteroscopy were 96%, 60%, and 92%, respectively. The specificity values of the three procedures examination were 12%, 84%, and 88%, respectively. No major complications or dissemination of malignant cells were evident. CONCLUSION: Ureteroscopic examination is a safe, sensitive, and specific means of detecting upper urinary tract tumors.     

Treatment of aggressive non-Hodgkin's lymphoma in elderly patients with thiotepa, Novantrone (mitoxantrone), vincristine, prednisone (TNOP)

The aging of the population and the increased incidence of non-Hodgkin's lymphoma will result in a large number of elderly patients with this disorder. Newer therapies will be required for this group of patients. This article reports a new therapy for elderly patients with diffuse aggressive non-Hodgkin's lymphoma. Patients were treated with TNOP (thiotepa 20 mg/m(2), mitoxantrone (Novantrone) 10 mg/m(2), vincristine (Oncovin) 1 mg/m(2) all on day 1 and prednisone 60 mg/m(2) on days 1 through 5 of a 21-day course. Twenty-six patients were enrolled on study. The patients' ages ranged from 66 years to 87 years, with a mean age of 75.5 years. Eleven patients had a partial response (42%) and 4 patients had a complete response (15%) for a total response of 57%. Eighty-one percent of patients survived 1 year and 54% survived for 2 years. The median survival was 26 months. Hematologic and nonhematologic toxicity was tolerable. We believe that TNOP is an excellent therapeutic option in this group of elderly patients, particularly in the palliative setting.     

Clinical outcome of high-dose chemotherapy combined with peripheral blood stem cell transplantation for male germ cell tumors

Peripheral blood stem cell transplantation (PBSCT) is widely performed currently instead of bone marrow transplantation (BMT) because bone marrow reconstruction is better and the procedure is less invasive. We applied 26 courses of high-dose chemotherapy (1250 mg/m2 of carboplatin, 1500 mg/m2 of etoposide and 7.5 g/m2 of ifosfamide) to 14 male patients with germ cell tumors. Eleven patients underwent high-dose chemotherapy as induction after two to three courses of conventional BEP therapy. The remaining three patients had recurrent disease after conventional chemotherapies. Peripheral blood stem cells were harvested during previous chemotherapy and sufficient CD34+ cells were harvested for transplantation. Although all patients had grade 4 hematotoxicity, the white blood cell count recovered to more than 1000/microl within 8-11 days after PBSCT. No treatment-related death was found. Nine of 14 patients (64.3%) remain disease free at 18 months of median follow up time (range 12-60). We conclude that high-dose chemotherapy is a safe and effective means of treating advanced or refractory germ cell tumors in male patients.     

Long-term follow-up results of a Pilot Phase II study of multidrug chemotherapy (MVP-CAB) in patients with advanced urothelial cancer.

BACKGROUND: To determine the long-term effects and toxicity of multidrug chemotherapy for advanced urothelial cancer. METHODS: Forty patients with metastatic urothelial cancer were treated with a new combination chemotherapy, MVP-CAB (methotrexate, doxorubicin, vincristine, cyclophosphamide, bleomycin and cisplatin every 28 days). Of the 40 patients, 26 had not undergone prior chemotherapy or radiotherapy; the remaining 14 patients had undergone prior cisplatin-based chemotherapy. RESULTS: The clinical response rate to MVP-CAB therapy for all 40 patients was 63% [complete response (CR), six patients; partial response (PR), 19 patients]. The median duration of the effects was 22 and 13 months in the patients with CR and PR, respectively. The clinical response rate for the 26 patients without prior chemotherapy was 77% (CR, four patients; PR, 16 patients). The rate for the 14 patients with prior chemotherapy was 36% (CR, two patients; PR, three patients). The response rate according to metastatic site was highest for the liver (80%), followed by the lymph nodes (74%) and lungs (67%). The effect on bone metastasis was poor (22%). There was good compliance with the MVP-CAB chemotherapy regimen and toxicity was tolerable. The 1-, 3- and 5-year overall survival rates were 42.5, 10 and 5%, respectively. CONCLUSIONS: MVP-CAB combination chemotherapy was found to be effective for the treatment of advanced urothelial cancer, especially for liver metastasis.