Application of Epstein-Barr virus (EBV) serology to the diagnosis of North American nasopharyngeal carcinoma

A cooperative study was established among a number of institutions in the USA to determine the clinical value of Epstein-Barr virus (EBV) serology for the diagnosis of different histopathological types of North American nasopharyngeal carcinoma (NPC) including occult primary tumors. One hundred-twenty-four patients with confirmed NPC have now been entered into the study. For each patient, anti-EBV antibody titers were determined at diagnosis and related to the histopathology as classified according to the World Health Organization (WHO). The results suggest that certain anti-EBV antibodies are of potential value for the diagnosis of undifferentiated types of NPC but not for the well-differentiated cancer. The IgA anti-VCA antibody response is the most specific for this disease and of the greatest diagnostic value when used alone or in combination with the anti-EA test. These tests have also been used successfully for the detection of occult NPC. These results indicate that these tests can be useful aids to the clinician for the diagnosis of certain histopathologic types of this disease.     

Progesterone receptors in carcinomas of the upper aerodigestive tract

This study had three major goals: (1) to vigorously verify the presence of progesterone receptors in squamous cell carcinoma of the upper aerodigestive tract (HN-SCC). Antiprogesterone receptor monoclonal antibodies revealed a distinct band at approximately 120 kilodaltons in samples taken from two of four patients with HN-SCC. These results illustrate that progesterone receptor in HN-SCC has the same molecular weight as progesterone receptor in normal human uterus and human breast cancer. Steroid specificity and saturability results support the evidence that it is true progesterone receptors that are measured and not other receptors or sex steroid-binding globulins; (2) to confirm the biochemical function of progesterone receptors in HN-SCC by assessing the binding of progesterone receptor to acceptor sites on chromosomes in the nucleus; and (3) to establish the clinical significance of progesterone receptor measurement. Patients with positive assays were more likely to be free of disease a mean of 6 months after resection. We used logistic regression to account for site of primary disease, grade of tumor, and stage of disease. This logistic regression was significant with a p = 0.014. Patients with a binding index greater than 2 (19 of 73 patients) were 4.34 times more likely to be free of disease than patients with negative assays.     

Synthèse de poly(oxyéthylène)s rendus biospécifiques par fixation de stéroïdes en extrémités de chaînes. Utilisation d'un poly(oxyéthylène) substitué par des groupes estradiol pour extraire l'isomérase Δ5→4 oxo-3 stéroïde,par partage d'affinité

In three consecutive steps involving halogenation, amination, and condensation with a convenient acyl derivative ( 1 or 2 ), α-hydro-ω-hydroxypoly(oxyethylene) ( 3 ) was transformed into poly(oxyethylene)s 7 containing 0,6 to 1,3 mol of 3-[3,17β-dihydroxy-1,3,5(10)-estratrien-7α-yl]butyroyl end groups or 0,7 mol of 3-oxo-4-androsten-17β-ylcarboxyl end groups per mol of polymer. Applying the method of affinity partitioning, the former poly(oxyethylene) derivative 7 was used to purify successfully Δ5→4 3-oxosteriod isomerase contained in a crude extract from Pseudomonas Testosteroni.     

Teacher verbalizations and task performance with autistic children

The purpose of this study was to investigate the effects of teacher verbalizations on the correct task performance of autistic children when positive reinforcement was presented in a noncontingent fixed-time schedule. Individual sessions were conducted using easy and difficult tasks with two autistic children. A within-subjects A-B-A-B withdrawal design was used. The results indicate that teacher verbalizations produced increases in the percentage of correct responding on difficult and easy tasks. This finding is discussed in terms of negative reinforcement and demand characteristics. The educational implications are also presented.     

Familial cancer of the parathyroid glands. Importance of angiography in the diagnosis of regional recurrences. Considerations on 2 cases]

The authors report two new cases of functional parathyroid carcinoma, the course of which varied between 5 and 7 years. The main fact was their familial character, as the disease affected two siblings. No similar case was found in the world literature. These two cases were characterised by symptoms in the bones or pancreatic symptoms which dominated the whole clinical course. Finally, the second case was studied by angiography which permitted the authors to localise a lymphnode metastasis on the opposite side. As far as treatment was concerned, the frequency and severity of local and regional spread justifies wide removal at an early stage. This attitude is necessary in any case of parathyroid tumor with an infiltrating character.     

Agreement between orthopedic surgeons and neurosurgeons regarding a new algorithm for the treatment of thoracolumbar injuries: a multicenter reliability study

INTRODUCTION: Considerable variability exists in the management of thoracolumbar (TL) spine injuries. Although there are many influences, one significant factor may be the treating surgeon's specialty and training (ie, orthopedic surgery vs. neurosurgery). Our objective was to assess the agreement between spinal orthopedic and neurologic surgeons in rating the severity of TL spine injuries with a new treatment algorithm. This information could be important in establishing consensus-based protocols for managing these challenging injuries. METHODS: Twenty-eight spinal surgeons (8 neurosurgeons and 20 orthopedic surgeons) reviewed 56 TL injury case histories. Each case was classified and scored according to the TL injury severity score (TLISS). The case histories were reordered and the physicians repeated the exercise 3 months later. At both intervals the surgeons were asked if they agreed with the final treatment recommendation of the TLISS algorithm. The reliability and decision validity of the TLISS was compared. RESULTS: Between-group interrater reliability was similar to within group reliabilities. Intrarater reliability was also similar between groups. The between speciality interrater reliability of the TLISS management recommendation was moderate (74% agreement, kappa=0.532). Orthopedic and neurosurgeons agreed with the TLISS management recommendation 91.4% and 94.4% of the time, respectively. CONCLUSIONS: The TLISS demonstrated good reliability in terms of intraobserver and interobserver agreement on the algorithmic treatment recommendations. The recommendation for operation seems to be consistent between fellowship-trained orthopedic and neurosurgical spine surgeons. This type of classification system may reduce the existing variability and initial management decision for treatment of TL injuries.