Postoperative radiotherapy for adenocarcinoma of the ethmoid sinuses: treatment results for 47 patients

PURPOSE: Ethmoid sinus cancer is a rare malignancy. Treatment results are mostly reported together with other sinonasal tumors, grouping a wide range of different histologies and treatment approaches. This study reports on the treatment outcome of 47 patients diagnosed with adenocarcinoma of the ethmoid sinuses and treated with surgery and high-dose postoperative radiation therapy. METHODS AND MATERIALS: Between September 1985 and October 2001, 51 patients with adenocarcinoma of the ethmoid sinuses were referred to the Ghent University Hospital. Four patients were treated with low-dose palliative radiation because of very extended inoperable disease or distant metastasis at the time of diagnosis. They were not included in this analysis. The other 47 patients, all staged as N0M0, were treated with surgery and postoperative high-dose radiation therapy. The median follow-up was 32 months. The T-stages were T1 for 2, T2 for 17, T3 for 11, and T4 for 17 patients. All 47 patients were staged as N0M0. RESULTS: The 3-year, 5-year, and 7-year overall survival are respectively 71%, 60%, and 38%. The 3-year and 5-year disease-free survival are respectively 62% and 36%. The 3-year and 5-year disease-free survival for T1-T2 stages are respectively 87% and 55%, for T3 stages 57% and 28%, and for T4 stages 41% and 25%. The locoregional tumor control was 70% and 59% at respectively 3 and 5 years. Patients presenting with intracranial tumor invasion at the time of diagnosis relapsed within 7 months after the end of radiotherapy. Radiation-induced severe dry eye syndrome and optic neuropathy was observed in respectively 7 and 2 of the 47 cases. CONCLUSION: Postoperative radiotherapy for adenocarcinoma of the ethmoid sinuses is associated with good local control rates. Crucial for a favorable prognosis is the absence of intracranial invasion. The rarity of these tumors makes it difficult to evaluate new therapeutic advances.     

Occipital brain perfusion deficits in children with major depressive disorder.

Occipital lobe perfusion defects have been identified on regional cerebral blood flow (rCBF) SPECT scans of adolescent children and young adults with major depressive disorder (MDD). We reinvestigated a series of rCBF SPECT scans obtained several years ago on drug-naive children with a clinical diagnosis of MDD and on healthy children. METHODS: To test whether visually apparent abnormalities in rCBF constitute statistically significant differences between patients, given the relatively small sample sizes, we applied the technique of statistical parametric mapping (SPM). RESULTS: Two groups of patients were identified: 8 with significant posterior flow deficits in the occipital cortex (Brodmann's areas 18 and 19), usually symmetric, and best visualized on paramedian sagittal sections, and 13 without obvious occipital perfusion deficits but with anterior rCBF deficits in a pattern often described in the literature, attaining statistical significance in the right frontal region. Other localizations in the left frontal and bilateral prefrontal regions did not attain significance, but each localization contained statistically significant maxima (z scores). The scan findings of all 18 healthy children were normal. CONCLUSION: With the aid of SPM, 2 groups of children with significantly different rCBF behavior were identified. The reason for this difference is not known but should be investigated to determine its possible significance to patients with MDD.     

Does deep endometriosis infiltrating the uterosacral ligaments present an asymmetric lateral distribution?

Objective To investigate whether deeply infiltrating endometriosis occurs with equal frequency between left and right uterosacral ligaments.
Design Retrospective analysis of consecutive cases.
Setting Department of gynaecological surgery in a tertiary care university hospital in Paris, France.
Population One hundred and thirty consecutive women with laparoscopic resection of histologically proven deep endometriosis infiltrating the uterosacral ligaments.
Methods Laterality, intraoperative aspect of the uterosacral ligaments, and associated endometriosis were recorded during laparoscopy. Deep endometriosis infiltrating the uterosacral ligaments was considered as histologically proven in the presence of endometrial glands and stroma.
Main outcome measure Frequency of left- and right-sided deep endometriosis infiltrating the uterosacral ligaments.
Results The left uterosacral ligament alone was involved in 69 cases; the right uterosacral ligament alone was involved in 38 cases; both were involved in 23 cases. For patients with unilateral deep endometriosis infiltrating the uterosacral ligaments the observed proportion of endometriosis involving the left uterosacral ligament (69/107, 64.5%) was significantly different from the expected proportion of 50% (   χ ²=8.98; P < 0.01  ).
Conclusion Anatomical differences between left and right hemipelvis and differences in the frequency of ovulation between right and left ovary could explain these results.     

Developmental changes in ERP correlates of spoken word recognition during early school years: a phonological priming study.

OBJECTIVE: We investigated event-related potential (ERP) correlates of developmental changes in spoken word recognition during early school years. We focused on implicit processing of word onsets as this may change considerably due to vocabulary growth and reading acquisition. METHODS: Subjects were pre-schoolers (5-6 years), beginning readers (7-8 years) and adults. Two experiments examined phonological onset priming effects on ERP measures in an auditory lexical decision task. Primes were words (Expt. 1) or non-words (Expt. 2). RESULTS: ERPs elicited by words showed clear developmental changes in ERP latency and morphology, especially with regard to early negativities like the N1. Prominent priming effects were an enhanced N400 amplitude due to alliterating word primes in beginning readers, and typical phonological N400 reductions due to alliterating non-word primes in all groups. Priming further led to opposite early effects with word primes (N1/N(200) reduction) vs. non-word primes (P1/N1 enhancement) in all groups. CONCLUSIONS: These changes in ERP morphology and priming effects suggest that the lexical system undergoes substantial restructuring at the level of phonological processing and representation. In particular, our results indicate distinct processing of word onsets in beginning readers, confirming that vocabulary growth and the acquisition of reading may critically contribute to the formation of a fully segmental lexical system.     

Benzoxazolinone phenylethanolamine antagonists of adrenergic receptors. A chemical and pharmacodynamic study

Benzoxazolinone can be considered as a bioisosteric analogue of pyrocatechol. This concept has led to the synthesis of benzoxazolinonic phenylethanolamines. The pharmacological study shows that these compounds possess an affinity for adrenergic receptors. Compound (XXXIV), the most interesting, is a competitive alpha and beta adrenergic antagonist which has been studied for antihypertensive activity.     

Computed tomography and lymphography in the presurgical staging of early carcinoma of the uterine cervix

The value of bipedal lymphography and computed tomography (CT) in the presurgical staging of early carcinoma of the uterine cervix was analysed in 62 patients by histologic examination of pelvic lymph nodes and parametrial extension at the time of surgery. Macroscopic invasion of the lymph nodes was detected in 33% of the patients by CT and in 17% by lymphography. Microscopic invasion was suspected in 9% by CT scan and in 38% by lymphography. Physical examination with measurement of the tumor diameter was more predictive for regional extension of the disease as compared to lymphography and CT. CT may detect subclinical parametrial invasion but overestimation of the extent of the disease is common. Bipedal lymphography and CT add only limited information to the routine presurgical staging of cancer of the uterine cervix.     

Single-photon tomographic determination of regional cerebral blood flow in epilepsy

Using a single-photon emission computed tomographic scanner (SPECT) the authors determined regional cerebral blood flow (rCBF) with inhaled xenon-133, a noninvasive procedure. Studies were performed in 40 normal individuals, and these were compared with rCBF determinations in 51 patients with seizure disorders. Although positive results were obtained in 15 of 16 patients with mass lesions, the group of principal interest comprised 25 patients suffering from "temporal lobe" epilepsy. Only one of these had a positive x-ray computed tomogram, but 16 had positive findings on rCBF study. These findings included increased local blood flow in the ictal state and reduced flow interictally.