Clinical Classification as a Guide to Treatment of Sinusitis in Children

Evaluation of all 153 children undergoing CT scan of the paranasal sinuses for recalcitrant sinusitis symptoms between January 1988 and July 1992 was performed. Clinical categorization into groups of patients presenting with chronic sinusitis (CS) and recurrent acute sinusitis (RAS) was based upon pattern of disease and presentation. Clinical symptoms and signs, radiological examination, treatment, and outcome were compared between these distinct clinical groups. Eighty-two (55%) children were categorized as RAS and 68 (45%) as CS. Children with CS presented more frequently with a persistent cough, purulent nasal discharge, immune deficiency, and more severe mucosal disease on CT than children with RAS. Medical therapy successfully controlled the symptoms of sinusitis in 79 (96%) with RAS versus 27 (40%) with CS. Surgery was performed in 44 children: 3 (3.6%) with RAS versus 41 (60%) with CS, p<0.01. At a mean follow-up of 2.0 years, >80% of all the children were either asymptomatic or improved regardless of treatment modality. These data support the use of clinical classification as a guide to medical versus surgical therapy in children with sinusitis.     

卵巢上皮性癌155例的治疗与预后

目的：探讨卵巢上皮性癌的治疗与影响预后的因素。方法：对１９７０年１月至１９９２年１２月在我院治疗的１５５例卵巢上皮性癌进行回顾性分析。全部手术切除标本经病理检查诊断并按ＦＩＧＯ分期标准进行分期，４２例行２次手术，４例行３次手术。除６例外，余１４９例均于手术后行化疗，３２例于第２次术后再次行化疗，９例因复发再次化疗。结果：２年、５年、１０年的生存率分别为Ⅰ期９２．４％、８７．０％、７０．６％；Ⅱ期９１．９％、６３．６％、４７．８％；Ⅲ期５９．９％、３８．２％、１９．２％；Ⅳ期２５．０％、２５．０％、０．０％（Ｐ＜０．００１）。６例未化疗者均在术后２年内死亡。结果表明，预后与临床分期、细胞分化、残留癌灶大小有关。５年生存率中，Ⅰ期为８７．０％和Ⅲ期为３８．２％（Ｐ＜０．００１）；Ｇ１的５年生存率为９５．９％，Ｇ３为１１．８％（Ｐ＜０．００１）；无残留癌灶者为９７．６％，残留癌灶＞２ｃｍ者为２１．２％（Ｐ＜０．００１）。结论：在卵巢上皮性癌初次手术时残留癌灶＜２ｃｍ，并于术后尽早开始化疗，可提高生存率。     

Solitary intracranial metastases from primary endometrioid ovarian cancer

A rare case of involvement of the Central Nervous System characterized by brain and subsequent cerebellar metastases without abdomino-pelvic spread is reported. The patient was treated by craniotomy plus external radiation to the brain. Subsequently, Carboplatin-based chemotherapy was started when paraaortic lymph-nodes involvement has been detected. Follow-up is uneventful after clinical complete remission. Received: 17 February 1997 / Accepted: 2 June 1997     

阴道彩超检测卵巢动脉主干血流对卵巢肿瘤定性诊断的研究

目的：研究用阴道彩色超声多普勒血流显象（ＴＶＳ－ＣＤＦＩ）技术检测卵巢动脉主干血流定性诊断卵巢肿瘤。方法：应用ＴＶＳ—ＣＤＦＩ技术检测正常妇女５６例、卵巢良性肿物６２例及卵巢恶性肿瘤３２例卵巢动脉总干血流的Ａ（收缩期末血流速度峰值）、Ｂ（舒张期末血流速度峰值）、ＰＩ（搏动指数）、ＲＩ（阻力指数）值，并观察其图型特点。结果：卵巢恶性肿瘤的Ｂ、ＰＩ、ＲＩ与正常卵巢及良性肿瘤测值差异有显著性（Ｐ＜０．０５）；恶性卵巢肿瘤内血管为低阻力血管，卵巢动脉主干也随之发生变化，致ＰＩ、ＲＩ降低；将ＰＩ＝１．２０，ＲＩ＝０．６２作为诊断卵巢恶性肿瘤的界值，其灵敏度、特异度、阳性预测值、阴性预测值指标与声像图诊断相比，均明显提高。结论：ＴＶＳ－ＣＤＦＩ检测卵巢动脉总干血流对鉴别卵巢肿瘤的良、恶性具有重要的意义。     

Abrogated energy-dependent uptake of cisplatin in a cisplatin-resistant subline of the human ovarian cancer cell line IGROV-1

The parental IGROV-1 human ovarian adenocarcinoma cell line was intermittently exposed to increasing concentrations of cisplatin to obtain resistant sublines. A stable resistant subline with a resistance factor of 8.4 had been developed after 9 months and 28 passages, which was denoted IGROV_CDDP. A high correlation coefficient of 0.97 was found between the log cell survival and the DNA-adduct peak level during the process of resistance development. IGROV_CDDP was strongly cross-resistant to carboplatin and doxorubicin and moderately cross-resistant to etoposide, docetaxel, and topotecan. Only minor resistance against 5-fluorouracil was observed, whereas IGROV_CDDP was not cross-resistant to methotrexate. Intracellular accumulation of cisplatin was 65% lower in IGROV_CDDP as compared with parental IGROV-1 at 37  °C under normal conditions. Coincubation of cisplatin with the Na⁺/K⁺-ATPase inhibitor ouabain resulted in a more pronounced decrease in platinum accumulation in IGROV-1 (44% decrease) than in IGROV_CDDP (26% decrease). Under energy-depleting conditions the accumulation of cisplatin in the parental cell line was approximately 60% lower than that observed under normal (energy [i.e., ATP] rich) culture conditions. In contrast, the accumulation in IGROV_CDDP was not affected by ATP-depletion. There appeared to be no significant difference between the intracellular accumulation of platinum in the resistant and sensitive cells under conditions of energy deprivation or when the uptake was studied at 0  °C. In conclusion, abrogation of energy-dependent accumulation in IGROV_CDDP seems to be a major mechanism of resistance to cisplatin in this cell line. Received: 21 January 1997 / Accepted: 22 July 1997     

肿瘤内血流检测对卵巢肿瘤定性诊断的研究

目的：评价多普勒血流显象技术检测卵巢肿瘤内血流定性诊断卵巢肿瘤的价值。方法：对疑诊卵巢肿瘤的75例（其中53例卵巢良性肿瘤和22例恶性肿瘤）于术前1w内行C超检查及肿瘤内血流检测，并与术后组织病理学诊断对照。结果：53例卵巢良性肿瘤中的21例（39．62％）及22例卵巢恶性肿瘤中的21例（95．45％）C超均显示其结构鼻常；在21例卵巢良性肿瘤内检测到血流高峰收缩速度（PSV）的均值为14．2±8．1cm／s，阻抗指数（RI）均值为0．478±0．119。当以PSV＝16cm／s为卵巢良、恶性肿瘤的界值时，PSV诊断卵巢恶性肿瘤的敏感性和特异性率分别为90．91％和90．57％；当以RI＝0．72为卵巢良、恶性肿瘤的界值时，RI诊断卵巢恶性肿瘤的敏感性和特异性率分别为86．36％和69．81％；C超诊断卵巢恶性肿瘤的敏感性和特异性率分别为95．45％和71．70％。三者的敏感性差异无显著性，而PSV诊断卵巢恶性肿瘤的特异性率明显高于RI和C超检查者，差异具有显著性（P＜0．05）。结论：用多普勒血流显象技术检测卵巢肿瘤内异常。流的PSV，对预测卵巢肿瘤性质具有一定的临床意义。     

Practitioner Review: Long-term Consequences of Childhood Cancer

Survival rates in childhood cancer now approach approximately 65%, depending on the specific cancer. Success has been achieved through the use of increasingly aggressive treatments (chemotherapy, radiotherapy, bone-marrow transplantation). These are now recognised to be associated with a range of physical late effects, including problems associated with growth and endocrine function, sensory function, fertility, liver, cardiac, and kidney damage. Recognition of these physical late effects raises the issue of related problems in psychological, educational, and behavioural functioning. There is considerable evidence to suggest that children who are younger on diagnosis are more at risk in terms of cognitive and behavioural late effects compared with those who are diagnosed later. Cancer remains a rare disease in children and consequently only those professionals attached to centres specialising in the care of children with cancer are likely to receive a significant number of referrals. It is important to establish a psychological support service as an integral part of long-term care in order to (a) establish more accurately the incidence of social and psychological late effects and (b) offer advice to the individual about the possible long-term effects of cancer treatment on future health, social, and employment prospects.     

Cytotoxic and anti-proliferative effects of high-energy pulsed ultrasound (HEPUS) on human squamous cell carcinoma cells as compared to connective tissue fibroblasts

The cytotoxic and anti-proliferative effects of high-energy pulsed ultrasound (HEPUS) on human squamous cell carcinoma cells cloned from the hypopharynx (FaDu) and benign connective tissue cells (fibroblasts) were investigated in vitro. Sonication was carried out using an experimental piezoelectric, self-focusing burst-signal transducer. To increase the induction of cavitation, the transducer used was specifically designed to produce multiple oscillations with a high negative pressure amplitude. In both cell lines tested, the application of 100, 800 and 2000 pulses resulted in a high reduction of vital cells. After 2000 pulses, 4.0 ± 1.1% of the fibroblasts but only 2.0 ± 0.4% of the FaDu cells survived HEPUS exposure. A postexposure inhibiting effect of HEPUS for 10 days on the proliferation of surviving cells was noted for the FaDu cells exposed to 2000 pulses, but not as much for the fibroblasts. These findings support the hypothesis that human squamous cell carcinoma cells of the hypopharynx might be more sensitive to HEPUS than fibroblasts and that total tumor cell ablation might be possible in vitro given a sufficient number of HEPUS pulses. Received: 18 November 1997 / Accepted: 21 April 1998     

胃癌细胞DNA／角蛋白双参数流式细胞术分析

５０例胃癌细胞ＤＮＡ含量和细胞增殖比率分别应用ＤＮＡ单参数和ＤＮＡ／角蛋白双参数流式细胞术进行了分析。结果表明：双参数方法可使细胞周期分析更准确，提高Ｓ期和Ｇ２／Ｍ期细胞比率的均值和准确性。将非胃上皮细胞和二倍体或四倍体肿瘤细胞组成的重叠直方图分离开来，且强调四倍体的Ｇ０／Ｇ１峰道，提高异倍体检出率。     

Preclinical in vivo antitumor activity of vinflunine, a novel fluorinated Vinca alkaloid

Vinflunine, or 20′,20′-difluoro-3′,4′-dihydrovino‐relbine, is a novel Vinca alkaloid obtained by hemisynthesis using superacidic chemistry. The most impressive structural modification of this vinorelbine derivative was the selective introduction of two fluorine atoms at the 20′ position, a part of the molecule previously inaccessible by classic chemistry. The antitumor activity of vinflunine was evaluated against a range of transplantable murine and human tumors. Vinflunine exhibited marked activity against murine P388 leukemia grafted i.v. when given i.p. in single or multiple doses according to various schedules or in single i.v. or p.o. doses. Increases in life span achieved with vinflunine, as assessed by T/C ratios, ranged from 200% to 457% and proved markedly superior to those of 129–186% obtained with the other Vinca alkaloids tested. Against s.c.-implanted B16 melanoma, multiple i.p. administration of vinflunine proved active in terms of both survival prolongation and tumor growth inhibition, with optimal T/C values and relative areas under the tumor growth curves (rAUC) being 24% and 36%, respectively. The extent of this activity was superior to that noted for vinorelbine under the same experimental conditions. Growth inhibition of human tumor xenografts LX-1 (lung) and MX-1 (breast) was also observed following four weekly i.p. injections of vinflunine as reflected by optimal T/C values of 23% and 26%, respectively, and significant differences in the rAUCs noted for treated versus control animals. It was also noticeable that vinflunine induced considerably more prolonged inhibitory effects on tumor growth than did vinorelbine. These results demonstrate that vinflunine is well tolerated and is definitively active against a range of experimental animal tumor models. Vinflunine activity has been documented in terms of both survival prolongation and tumor growth inhibition, with definite superiority over vinorelbine being shown in each tumor model evaluated. Received: 13 July 1997 / Accepted: 21 October 1997