Leiomyosarcoma of the nasal cavity and paranasal sinuses

A case of leiomyosarcoma of the nasal cavity and paranasal sinuses is presented along with a review of the medical literature. The clinicopathological aspects of this tumor are discussed. The mode of treatment is complete surgical excision with close follow-up due to its high rate of local recurrence. The long-term survival with recurrent disease in this case is unusual.

Effect of concomitantly administered drugs on the control of long term anticoagulant therapy

The stability of control of long term anticoagulant therapy was studied in a group of 277 patients with respect to drug interactions. Increased instability (changes of dose/month of therapy) was related to the number of concomitant drugs taken irrespective of, and in addition to, known specific interactions. Fluctuating cardiac status in patients requiring digoxin and diuretic therapy was a major factor in stabilizing anticoagulant control.

Foam-stability test on gastric aspirate and the diagnosis of respiratory-distress syndrome

Gastric aspirate, collected from 79 infants within 30 minutes of birth, was subjected to the foam-stability test. The lecithin/sphingomyelin ratio was determined in 27. The results were compared with the incidence of respiratory-distress syndrome as determined independently by different investigators. Of the 59 infants with a positive foam-stability test on gastric aspirate, three had transient respiratory distress, and one the respiratory-distress syndrome; 17 of 22 had lecithin/sphingomyelin ratios greater than 2.0. Of nine infants who had intermediate test results, three were normal, four had transient respiratory distress, and two had the respiratory-distress syndrome. In all the 11 infants with negative foam-stability tests the respiratory-distress syndrome developed. The three gastric aspirates tested in this group had lecithin/sphingomyelin ratios of less than 1.5. These data indicate that the foam-stability test on gastric aspirate is a reliable index of fetal lung maturity in infants whose amniotic fluid is not available.

Radiobiological studies of a high-energy modulated proton beam utilizing cultured mammalian cells

The modulated, 160-MeV proton beam produced by the Harvard Cyclotron has been examined in detail for its ability to kill mammalian cells as assayed by colony forming ability. Using two different cell exposure techniques, the characteristics of position and total dose in producing cell death in two aneuploid cell lines selected for their radiobiological relevance have been determined...

Conformation therapy using the tracking cobalt unit

A description is given of the principles and application of the tracking technique using an automated cobalt teletherapy unit. The technique is a combination of moving table and arcing techniques which is used to shape the irradiated volume to match the tumour volume in three dimensions. The method has the additional advantage that corrections can be made for variations in dose rate along the tumour axis resulting from changes in body outline and the presence of inhomogeneities. An outline of the treatment planning procedure and the way the machine executes the planned treatment is given. Isodose distributions ar presented for two cases for which the technique was employed. The first of these illustrates the treatment of an oesophageal tumour, showing how the technique can be used to compensate for an irregularly shaped tumour in a part of the body having a large variation in cross section. The second shows how the technique copes with a tumour having a regular shape but having an awkward orientation in the body. Brief reference is made to work at other centres using moving table and three-dimensional shaping techniques which employ synchronous shielding.

Repair of DNA strand breaks in progeric fibroblasts and aging human diploid cells

The rate of rejoining of DNA strand breaks induced by 10 krad of gamma-irradiation has been studied in normal human diploid skin fibroblasts and in skin fibroblasts from six patients with symptoms of progeria. Although slightly more rapid in very early passage, the repair rate in normal cells was similar throughout most of their life span in vitro. The appearance of cells with reduced repair capacity was evident as the cultures became senescent. The progeric fibroblasts varied greatly in their response to irradiation. The rate of repair was greatly reduced in two strains, whereas in two others extensive DNA degradation was consistently observed in unirradiated cells. Degradation was apparently related to the radiation received from the incorporated radiolabel. Normal repair was seen in progeric fibroblasts transformed by SV40 virus.

Deficient DNA repair in human progeroid cells

Skin fibroblasts biopsied from a patient with clinical symptoms of the Hutchinson-Gilford progeria syndrome failed to show evidence of normal DNA strand rejoining in vitro after exposure to cobalt-60 gamma irradiation. Control human diploid fibroblasts of fetal origin in early passage, skin fibroblasts of adult origin, and an established line of human liver cells (LICH) all showed essentially complete rejoining of radiation-induced strand breaks within 30 min after irradiation, as evidenced by DNA sedimentation profiles in alkaline sucrose gradients. The results suggest that an enzyme involved in DNA repair may be absent or greatly reduced in efficiency in cells from this patient with the progeria syndrome. Such a repair-deficient cell strain may prove useful in the study of the molecular events associated with x-ray-type damage and its repair in mammalian cells.

Cubital tunnel external compression syndrome

External compression of the cubital tunnel comprises the acute and subacute forms of ulnar nerve compression at the elbow. Subacute compression is often seen in hospital practice and sometimes results in partial crippling of the hand. Prognosis for complete recovery is poor. Avoidance of a position of the elbow which predisposes to external compression of the ulnar nerve within the cubital tunnel is advised when a patient is on the operating table, in bed or in an armchair. Prolonged severe elbow flexion in these circumstances should also be avoided. The patient suffering from the syndrome should be instructed to avoid further pressure so that worsening of the palsy is minimized. A compressed nerve is likely to be more sensitive than a normal nerve to ischaemia produced by subsequent pressure. Surgical treatment is sometimes indicated at least to halt progression of the palsy.