Epidermoid cancers of the esophagus: combined chemotherapy, surgery and radiotherapy. Preliminary results in 50 cases

Fifty operable epidermoid esophageal carcinomas were treated by combined chemotherapy, surgery and radiotherapy. The post-operative mortality was 5.4% and the severe post-operative morbidity was 29%. The vindesine-5FU-platinum association and the vindesine-endoxan-platinum association gave respectively 55% and 35% objective responses (OR) after two preoperative courses without increasing the operative mortality. The patients who showed an OR had a less important tumoral extension. Thus, an objective response to the pre-operative chemotherapy is in fact a new prognostic factor. Survival without recurrence seems to be increased when chemotherapy is efficient in the curative resection group. These findings incite to promote prospective randomized studies with this kind of combined therapy.     

Intraepidermal cell surface fine structure: preservation and examination at high resolution.

Morphological and functional studies on cell surfaces have been limited largely to cultured cells because of injury wrought to cells of solid tissues by commonly employed mechanical, enzymatic, or chelator dispersal methods. By using the staphylococcal epidermolytic toxin we avoided this problem; the toxin cleaves the intercellular spaces of human and mouse squamous epithelia without ultrastructural evidence of cytotoxicity. We studied the cell surface topography of neonatal mouse epidermis obtained two hours after injection of highly purified epidermolytic toxin. Immediately after sacrifice intraepithelial surfaces were exposed while the animals were immersed in fixative. Specimens were either freeze-fractured or embedded for transmission electron microscopy, or were critical-point-dried prior to platinum/carbon replication for transmission and scanning electron microscopy. Replicas could be prepared for transmission electron microscopy only if they were first stabilized with parloidion and then cleaned with both bleach and 40% chromate. By using these four complementary morphological methods (freeze-fracture, scanning electron microscopy, transmission electron microscopy of surface replicas, and standard thin sections), we could positively identify external membrane structures. The convoluted surface was studded by tenuous microvilli, scattered 15-20 nm particles, and hemispherical desmosomal mounds. Desmosomal plaques displayed randomly arrayed 15-20 nm globular particles comparable in distribution and density to particles observed in freeze-fractured desmosomes, and suggesting that desmosomal integral membrane particles span the external leaflet of the plasma membrane.     

The accuracy of aspiration cytology in the diagnosis of rejection following orthotopic liver transplantation

Abstract. The role of aspiration cytology (AC) and the total corrected increment (TCI) in the diagnosis of hepatic rejection was assessed in 30 patients following 36 liver transplants. A total of 174 AC specimens were "blindly" evaluated. Patients underwent protocol AC twice weekly and when biochemical or clinical parameters suggested rejection. Hepatic rejection was only confirmed when clinical and biochemical changes were accompanied by positive histological diagnosis. In all, 103 specimens were matched against histology, the remainder assessed against retrospective clinical and biochemical diagnoses. There were 80 cytological diagnoses of rejection, confirmed in 69 specimens, and 94 diagnoses of no rejection, confirmed in 73 specimens. These figures give a sensitivity of 76.7%, a specificity of 86.9% and a positive predictive value of 86.3%. Overall, 39.7% of specimens taken more than 2 months after grafting proved to be incorrectly diagnosed. However, the accuracy was higher in 145 specimens taken within 8 weeks of transplantation, with a sensitivity of 81.3%, a specificity of 90%, a positive predictive value of 89.7% and an accuracy of 85.5%. Although histology remains the gold standard in the diagnosis of acute rejection after hepatic grafting, AC using a TCI with a positive predictive value of 86.3% may prove to be of value in monitoring liver transplant patients in the first 2 months after grafting.     

Changes in the hamster liver after experimental infection with Schistosoma intercalatum. An ultrastructural study.

Syrian hamsters were exposed to cercariae of Schistosoma intercalatum. After 70 days, their livers were fixed by vascular perfusion and samples of liver tissue were studied by the electron microscope. Lesions consisted predominantly of mature egg granulomas, with some in earlier stages of development. The cells involved in both types of lesion are described together with their relation to the egg and the surrounding liver tissue. Only minor abnormalities were seen in the tissue distant from the eggs. These consisted mainly of (a) pigment accumulation, both in Küpffer and endothelial cells; (b) probably aspecific ultrastructural changes in the hepatocytes; (c) occasional slight fibrosis around portal veins. The Schistosoma pigment was compared with malaria pigment induced by infection of a hamster with Plasmodium berghei. The regular, crystalloid hemozoin particles in malaria infection were easily distinguishable from the coarser and irregular pigment deposits in schistosoma infection.     

Cerebral asymmetry in word-object matching by appearance and by function

Subjects were asked to say whether a word presented monaurally to the right or left ear matched a presented object. Analysis of vocal response latencies indicated that words relating to the function of the object were responded to more quickly when presented to the left ear and, by inference, the right hemisphere. Words relating to a physical characteristic of the object (e.g. color) were responded to more quickly when presented to the right ear and, by inference, the left hemisphere.