[Immunocytochemical characterization of malignant pleural effusions of small cell bronchial cancer]

In pleural effusions, histologically proven to be malignant in 13 patients with small cell lung cancer, the immunocytological profile of tumour cells, together with the distribution of the lymphocyte subpopulations, were established. In all cases, tumor cells were demonstrable with the monoclonal antibodies EMA, HEA-125, Sam 2, 6, 8 and 10. In contrast, conventional cytology was positive in only 6 of the 13 cases. As in other malignant or inflammatory effusions, phenotyping of the lymphocytes revealed an elevated T4/T8 ratio in comparison with the normal value for peripheral blood.

[Sequential alternating chemotherapy of highly malignant non-Hodgkin's lymphomas with VIM-Bleo and CHOP. Initial results]

54 patients with high grade malignant NHL (stage II 19, stage III 10, stage IV 25 patients, medium age 56 years) were treated in an ongoing study with the VIM-Bleo/CHOP-regimen: Etoposide 100 mg/m2 i.v. days 1-3, Ifosfamide 1.5 g/m2 i.v. days 1-5 with Mesna for prophylaxis of cystitis, Methotrexate 30 mg/m2 i.v. day 3, Bleomycin 10 mg i.v. days 8 and 15, Cyclophosphamide 750 mg/m2 day 22, Adriamycin 50 mg/m2 day 22, Vincristine 1.4 mg/m2 day 22 and prednisolone 100 mg po days 1-5 and 22-26. Cycles were repeated on day 43. After completion of therapy (4 cycles of VIM-Bleo/CHOP), 27 out of 35 patients (77%) were in complete remission. 6 patients (17%) had a partial remission and 2 (6%) progressive disease. After a median follow up of 8 months so far, 6 relapses occurred. Probability of survival at 12 months is 82%. Toxicity of treatment was very low with leukopenia being the main side effect. Only in 2 cycles (3%), major infections were observed. Nausea and vomiting were severe only in 4% of patients. We conclude that VIM-Bleo/CHOP is a well tolerated regimen with good remission rates in high grade malignant NHL. However, longer follow up is necessary for a final evaluation.

Enolase isoenzymes as tumour markers

alpha- and gamma-enolase isoenzyme substance concentrations were measured in serum and plasma from healthy subjects and from 174 patients with different solid tumours. While alpha-enolase was found to be increased in the plasma of patients with tumours of quite different origin, gamma-enolase apparently reflected malignancies of the neuroendocrine system. Before the beginning of the cytotoxic therapy gamma-enolase was increased above the upper limit of the reference range (10 micrograms/l) in 27/27 patients (100%) suffering from small cell lung cancer. Most patients with squamous cell carcinoma of the lung or with prostatic cancer exhibited normal gamma-enolase, while both tumour types produced high plasma substance concentrations of the alpha-isoenzymes of enolase.

[Neo-adjuvant chemotherapy of head and neck cancer]

Pre-operative chemotherapy with vincristine, moderately high doses of methotrexate plus "rescue", and bleomycin for six weeks was administered to 26 patients with untreated carcinoma of the head and neck. Treatment was well tolerated and compliance was very good. Objective side effects necessitated ending treatment in ten patients. Tumour regression of over 50% (responders with partial or complete remission) was recorded in 17 patients; five of them had no histological evidence of tumour in the surgical specimen. In three patients the tumour regressed slightly, in two it remained unchanged and in four it had progressed at the end of treatment (nine non-responders). After a minimum observation period of 36 months 12 of the 26 patients were still alive. Median survival time had not yet been reached in the 17 responders. But the median survival time of the non-responders was 15 months. It is concluded that this form of treatment is very effective and well tolerated. If response is achieved it opens the prospect of prolonged survival time.

[Subcutaneous tenotomy of the sternocleidomastoid muscle as therapy in muscular torticollis]

This study reviews the cases of 49 patients with congenital muscular torticollis after an average follow-up of seven years, who were treated with subcutaneous sternomastoid tenotomy. An excellent result was found in 18 patients (37%), a good result in another 18 patients (37%), while the result of 13 patients (26%) must be regarded as unsatisfactory. There were no severe complications to be seen. These results are compared with other operative technics of treatment of muscular torticollis and the poor results are analyzed. We believe that subcutaneous sternomastoid tenotomy is a good method for treatment of muscular torticollis, with the advantage of avoiding any ugly scar.

[Antibiotic concentrations in wound secretions and bone during the simultaneous administration of mezlocillin and oxacillin]

Mezlocillin and oxacillin have been used in combination for short-term antibiotic prophylaxis in orthopedic surgery. Antibiotic concentrations were measured in serum, wound secretions from subcutaneous tubings and bone. Half an hour after the i. v. application of 4 g mezlocillin + 2 g oxacillin, the concentrations in wound secretions were 20% of the serum levels. After four hours the levels of both antibiotics in wound secretions increased to 2.66 times the serum levels of mezlocillin, and 5.37 times those of oxacillin. After eight hours the concentrations in wound secretions dropped to about one half, but remained well within therapeutic levels. The parallel course of the concentrations of both antibiotics in wound secretions indicates that mezlocillin and oxacillin have very similar half-lives in wound secretions, although the serum half-lives (t 50% beta) of the two antibiotics are different. The concentrations obtained from cancellous bone were approximately. 10% of the serum levels one to two hours after the antibiotic infusion.