Cytotoxic chemotherapy for patients with terminal squamous carcinoma--does it influence survival?

The absence of any good scientific evidence that a single cytotoxic chemotherapy regimen is effective in the palliation of squamous carcinoma of the head and neck is reflected in the diverse manner with which palliative chemotherapy is used in the UK. We conducted a survey of the members of the Association of Head and Neck Oncologists of Great Britain: 70% of the specialists questioned used palliative chemotherapy for head and neck cancer. Bleomycin was cited by 80% of the chemotherapy users, whereas cisplatin was cited only by 35%. We also report the results of a controlled trial of palliative chemotherapy in head and neck cancer. Cisplatin prolonged survival and time spent at home but Bleomycin did not. Also there appeared to be a synergistic effect between Cisplatin and Bleomycin.     

The aetiology of chronic laryngitis.

Fifty-eight patients with chronic laryngitis, defined as diffuse laryngeal inflammation, of an average duration of approximately 1 year, were investigated. The sex incidence was equal and the average age 45 years. Occupational factors were of minor importance, and the smoking habits of the patients were the same as those of a similar matched population. Of the haematological factors investigated, anaemia, diabetes, renal disease and syphilis were of no importance whatsoever. The most important aetiological factor was sepsis of the upper and lower respiratory tracts which was present in over half the patients.     

Replacement of the pharynx after pharyngolaryngectomy

Twenty-two patients undergoing pharyngolaryngectomy and pharyngeal reconstruction are presented. Four patients died before leaving hospital swallowing. Fistulae and stricture formation were fairly common in patients who had been previously irradiated. The 2-year survival was 37%.     

Functional complications following supraglottal laryngectomy

85 patients who had undergone supraglottic laryngectomy was necessary including the removal of one arytenoid cartilage or one vocal cord which was replaced by a thyroid cartilage graft. The latter group had greater difficulty in learning to swallow, a longer stay in hospital, more deaths as a result of lung infection, and an increased incidence of later lung infection.     

Tumour growth rates in squamous carcinoma of the head and neck measured by in vivo bromodeoxyuridine incorporation and flow cytometry.

The cell kinetics of 82 squamous cell carcinomas of the head and neck were studied by in vivo administration of the thymidine analogue, bromodeoxyuridine (BrdUrd). Ploidy, BrdUrd labelling index (LI), duration of S-phase (Ts), potential doubling time (Tpot) and S-phase fraction (SPF) were measured by flow cytometry on 50 microns paraffin embedded sections. The range of values obtained compared well with other in vivo cell kinetic studies of head and neck cancer. Aneuploid tumours had a significantly higher BrdUrd labelling index and SPF, and a short Tpot than diploid tumours. To validate the use of 50 microns sections for measuring cell kinetic parameters by flow cytometry a comparison of values obtained by 50 microns sections and small blocks of tissue was made. No significant difference was found between the two methods. Reproducibility of values between two consecutive thick sections was also good. We conclude that reproducible cell kinetic measurements can be made in tumour samples using 50 microns sections of BrdUrd labelled tissue.     

Evidence for FMRF-amide as a neurotransmitter in the gill of Aplysia californica

In Aplysia californica, multiple regulatory mechanisms are involved in the actions of neurotransmitters on the gill. Neurotransmitter receptors and adenylate cyclase were examined in a particulate fraction of gill homogenates. The neuropeptide FMRF-amide stimulated enzyme activity 7- to 8-fold (EC50, 1 microM) via receptors that were pharmacologically distinct from those for dopamine and serotonin. FMRF-amide augmented cyclic AMP levels in slices of gill tissue with a time course similar to that for adenylate cyclase activation. Increases in cyclic AMP levels produced by the neuropeptide were potentiated by the phosphodiesterase inhibitor theophylline. Physiological responses to neuropeptides and cyclic AMP analogues were examined in a perfused, isolated gill preparation. Phasic contractions evoked by FMRF-amide (EC50, 0.1 microM) were mimicked by membrane-permeable analogues of cyclic AMP. Comparison of FMRF-amide effects on adenylate cyclase and gill behavior suggests an association between cyclic AMP and phasic contractions. In addition, FMRF-amide-like immunoreactivity, detected by antisera raised against the neuropeptide, was found in nerve fibers innervating the gill. These findings indicate that in Aplysia, FMRF-amide or a closely related peptide neurotransmitter may be involved in the physiological regulation of gill behavior.