Volume correction factor in time dose relationships in brachytherapy

Paterson's clinical data about the maximum tolerance doses for various volumes of interstitial implants with Ra-226 delivered in seven days was made use of in deriving volume correction factors phi v and phi'v for TDF and CRE concepts respectively for brachytherapy. The derived volume correction factors phi v for TDF and phi'v for CRE differ from the from the one assumed for CRE by Kirk et al. and implied for TDF by Goitein. A normalising volume of 70 cc has been suggested for both CRE and TDF concepts for brachytherapy. A table showing TDFv, the volume corrected TDF, is presented for various volumes and dose rates for continuous irradiation. The use of this table is illustrated with examples.

Mandibular osteomyelitis caused by Actinomyces Israelii. Report of a case

An unusual case of cervicofacial actinomycosis with cortical osteomyelitis of the ascending ramus is presented. The portal of entry of the infection was most probably by an extra oral route. The authors have emphasized the importance of repeated smear examinations, cultures, and sensitivity tests to rule out actinomycosis in such cervicofacial infections. The difficulties encountered in the isolation of A. Israelii are discussed.

Osteomyelitis of the mandible in marble bone disease

Marble bone disease is a rare skeletal disorder. Osteomyelitic changes in the jaw bones are frequently seen in this disease. Considering the rarity of the disease, a case of osteomyelitis of the mandible in marble bone disease is presented, together with a review of the available literature.

Odontoameloblastoma

A case of odontoameloblastoma affecting the left mandible is reported. Initially treated by conservative excision due to its small size, the lesion recurred after 18 months and was treated by radical excision and subsequent reconstruction by a rib graft.

Myelin basic protein and demyelinating diseases

Myelin basic protein (MBP) is a major protein component of myelin sheath. Primarily because of its ability to induce experimental allergic encephalomyelitis (EAE) in animals, this protein has been considered to play an important role in the pathogenesis of multiple sclerosis (MS), which is one of the most common demyelinating diseases. Its precise measurement in the cerebrospinal fluid (CSF) has been uncommonly difficult, mainly due to immunoheterogeneity of MBP or MBP-like material. More recently, highly sensitive radioimmunoassay techniques utilizing well-characterized antisera have been developed that facilitated its use in the management of MS. The clinical course of MS is highly variable, and the disease is characterized by periods of remission and relapses. Many studies have demonstrated the release of MBP during relapses and elevated levels of MBP in the CSF can be detected if lumbar puncture is performed within 7 days of the onset of neurologic symptoms suggestive of MS. However, the presence of MBP is not an absolute indicator of MS, as elevated MBP levels are also frequently observed in other demyelinating diseases.

Autoimmune thyroiditis in manic-depressive patients treated with lithium

To explore whether lithium-induced hypothyroidism is related to an exacerbation of underlying autoimmune processes such as thyroiditis, the authors comprehensively assessed thyroid function in 16 manic-depressive patients. Each of the three patients who showed detectable titers of thyroid microsomal antibodies before treatment manifested a marked increase in antibody titer from 4 to 12 months after lithium treatment was begun. Thus, lithium-induced thyroid dysfunction may not only involve direct effects on the thyroid itself but also involve exacerbation of an underlying indolent autoimmune thyroiditis, possibly by causing shifts in T lymphocyte subpopulations.

Measurement of a monoclonal-antibody-defined antigen (CA19-9) in the sera of patients with malignant and nonmalignant diseases. Comparison with carcinoembryonic antigen

Immunoradiometric assay (IRMA) using monoclonal antibody for colon cancer cell surface antigen (CA19-9) was compared with carcinoembryonic antigen (CEA) with regard to sensitivity and specificity in 730 patients. In the 341 patients who had no evidence of malignant disease, CA19-9 levels ranged between less than 1.5 to 49 U/ml. Specificity of CA19-9 at a cutoff of 20 U/ml was similar to that of CEA at a cutoff of 5.0 ng/ml; CA19-9 was more sensitive than CEA in pancreatic cancer, whereas CEA was more sensitive than CA19-9 in breast, colon, and gastric cancer. Of 17 patients with pancreatic cancer, 13 had elevated levels of CA19-9 (sensitivity, 76%), whereas only 8 had elevated levels of CEA (sensitivity, 47%) and 15 had elevated levels of either CEA or CA19-9 (sensitivity, 88%). These findings suggest that, like CEA, CA19-9 is detectable in nonmalignant diseases and is not specific for gastrointestinal tumors, and has higher sensitivity than CEA only in pancreatic cancer. However, further prospective studies are required to verify its value in the diagnosis and management of pancreatic cancer.

Measurement of a monoclonal-antibody-defined antigen (CA19-9) in the sera of patients with malignant and nonmalignant diseases. Comparison with carcinoembryonic antigen

Immunoradiometric assay (IRMA) using monoclonal antibody for colon cancer cell surface antigen (CA19-9) was compared with carcinoembryonic antigen (CEA) with regard to sensitivity and specificity in 730 patients. In the 341 patients who had no evidence of malignant disease, CA19-9 levels ranged between less than 1.5 to 49 U/ml. Specificity of CA19-9 at a cutoff of 20 U/ml was similar to that of CEA at a cutoff of 5.0 ng/ml; CA19-9 was more sensitive than CEA in pancreatic cancer, whereas CEA was more sensitive than CA19-9 in breast, colon, and gastric cancer. Of 17 patients with pancreatic cancer, 13 had elevated levels of CA19-9 (sensitivity, 76%), whereas only 8 had elevated levels of CEA (sensitivity, 47%) and 15 had elevated levels of either CEA or CA19-9 (sensitivity, 88%). These findings suggest that, like CEA, CA19-9 is detectable in nonmalignant diseases and is not specific for gastrointestinal tumors, and has higher sensitivity than CEA only in pancreatic cancer. However, further prospective studies are required to verify its value in the diagnosis and management of pancreatic cancer.

Pan-mandibular keratocyst with eosinophilia

A case of pan-mandibular keratocyst with eosinophilia is presented. The authors have not so far in the literature come across such an extensive cystic lesion involving complete mandible and showing no preponderant signs or symptoms.

Effectiveness of castration versus intravenous estrogen therapy in producing rapid endocrine control of metastatic cancer of the prostate

Nine men with histologically confirmed stage D cancer of the prostate were evaluated with serial serum testosterone levels after being treated with bilateral orchiectomy or intravenous estrogen. Bilateral orchiectomy produced castrate serum testosterone levels (less than or equal to 50 ng. per 100 ml.) within 2 to 6 hours (mean 3 hours) after surgery. Intravenous estrogen therapy did not consistently produce castrate serum testosterone levels immediately but did significantly decrease testosterone within 12 hours after infusion. Both forms of therapy are safe, produce a clinically effective response and offer advantages for patients with advanced prostatic cancer.