Fronto-sternal traction: an adjunct to orthognathic surgery

A case is reported in which an unexpected occlusal result arose following bimaxillary osteotomy for correction of a skeletal Class III discrepancy. In order to correct the occlusion, the mandible was protracted independently of the recently plated maxilla, by means of a fronto-sternal traction device.

Effect of pilocarpine on anterior chamber angles

Pilocarpine is widely used in the treatment of glaucoma, especially for the acute form of angle-closure glaucoma. Previous studies have shown that pilocarpine decreases central anterior chamber depth. In the present study, a quantitative measurement method, applying Scheimpflug photography, was used to report whether pilocarpine also affected the anterior chamber angles. Twenty-nine normal Chinese subjects, 17 female and 12 male with an age range from 11 to 63 years old, were enrolled. One eye of each subject was treated with one drop of 2% pilocarpine. Photographs of each of four quadrants were taken prior to, and after, pilocarpine treatment in both eyes, using a rotating slit-lamp video camera based on the Scheimpflug principle. The slit beams were set at 0 degrees and 90 degrees. The eyes which did not receive pilocarpine treatment served as control. The angles of the four quadrants were calculated for both eyes both prior to, and after, pilocarpine treatment, and results were compared by Student's paired t-test. The comparison of angles between the eyes prior to, and after, pilocarpine treatment indicated that there is a significant narrowing of angles in all quadrants. The complex factors involved in the change of anterior chamber angle are reviewed in the light of muscarinic action of pilocarpine.

Kinetic analysis of the interaction between the diphosphate of (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine, ddCTP, AZTTP, and FIAUTP with human DNA polymerases beta and gamma

The inhibitory effects of the diphosphate of (S)-1-(3-hydroxy-2-phosphonylmethoxy-propyl)cytosine (HPMPCpp) toward human DNA polymerases beta and gamma were studied. The Ki values of HPMPCpp were compared with the Ki values of the triphosphates of 3'-azidothymidine (AZTTP), 2',3'-dideoxycytidine (ddCTP) and 5-iodo-2'-fluoroarabinosyluridine (FIAUTP). The Ki values toward DNA polymerase beta in increasing order were 1.32, 1.43, 140, and 520 microM for ddCTP, FIAUTP, AZTTP and HPMPCpp, respectively. The Ki values toward DNA polymerase gamma in increasing order were 0.034, 0.031, 18.3 and 299 microM for ddCTP, FIAUTP, AZTTP and HPMPCpp, respectively. Therefore, HPMPC would be expected to have less inhibitory effects on DNA repair (DNA polymerase beta) and mitochondrial DNA synthesis (DNA polymerase gamma) than ddC, FIAU or AZT.

Expression of multiple neuregulin transcripts in postnatal rat brains

The distribution of neuregulin transcripts in rat brains was studied by both RNA blotting and in situ hybridization. Our data demonstrate that multiple neuregulin transcripts are expressed in neurons of the basal forebrain, the hippocampus, the diencephalon, the cerebellum, the brainstem, and the spinal cord. Developmental changes in the distribution of neuregulin transcripts were observed only in the cerebellum and the hippocampus. The intense neuregulin hybridization signals in the brainstem motor and sensory nuclei and the spinal motor neurons are suggestive of a functional involvement of neuregulins in motor and sensory systems. The expression of neuregulins in other parts of the brain also indicates that these factors are involved in a variety of central nervous system functions.

Comparison of the levels of the major allergens Der p I and Der p II in standardized extracts of the house dust mite, Dermatophagoides pteronyssinus

Allergy to the house dust mite Dermatophagoides pteronyssinus is mediated by IgE to the major allergens Der p I and Der p II in the majority of mite-allergic patients. In recent years, standardized preparations of D. pteronyssinus, commercially available from several sources, have become widely used for the diagnosis and immunotherapy of mite allergy. As standardization implies uniformity of allergen composition and potency, we directly compared the absolute and relative quantities of Der p I and Der p II in six different commercial standardized extracts of D. pteronyssinus. Our findings reveal variability in levels of both Der p I and Der p II, producing ratios of Der p I/Der p II ranging from 1.1/1 to 6/1. Although the content of minor allergens in the extracts was not evaluated here, their contribution to the overall reactivity of mite-allergic patients to the commercial extracts was judged to be minimal. This was demonstrated by showing that plasma depleted of reactivity to both Der p I and Der p II had virtually no residual IgE directed against extract components. The variation in the proportion of Der p I and Der p II among different D. pteronyssinus extracts is likely to influence their biological effectiveness. Patients with reactivity against only Der p I or Der p II, who were found to comprise approximately one-third of the mite-allergic population, may not respond optimally to extracts containing relatively low levels of the allergen to which they are sensitive.

Experimental myopia in chickens induced by corneal astigmatism

Astigmatism has been suggested to be an important factor in the production and/or progression of myopia. Chickens have been used as a myopic animal model for several years. In the present investigation our aim was to evaluate the importance of surgically induced corneal astigmatism by peripheral corneal incision with compression suture in one eye, the right, of 3-day-old chicks. Vertical incision (2 mm) with compression suture (nylon 9-0, one stitch) induces against-the-rule astigmatism, horizontal incision with compression induces with-the-rule astigmatism. Four groups were studied 1) with one vertical cut, 2) one horizontal cut, 3) two vertical cuts, 4) two horizontal cuts. The eyes were measured by caliper after 8 weeks. Eye enlargements were induced in all groups, however, less by one cut (astigmatism around 5 diopters) than by two cuts (astigmatism 10 diopters, or more). In the latter groups the pattern of equatorial eye enlargement depended on the axis of the induced astigmatism, the greater elongation being associated with the strongest refracting corneal meridian. All considered, the results suggest that significant corneal astigmatism could be another factor in the production of myopia, possibly acting by way of optical degradation of retinal image quality.

1-[((S)-2-hydroxy-2-oxo-1,4,2-dioxaphosphorinan-5-yl)methyl] cytosine, an intracellular prodrug for (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine with improved therapeutic index in vivo

1-[((S)-2-hydroxy-2-oxo-1,4,2-dioxaphosphorinan-5-yl)methyl]cytosi ne (cyclic [cHPMPC]) was evaluated as a novel antiviral agent in comparison with (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC). Evaluation for in vitro activity against herpes simplex virus type 2 in MA-104 and MRC-5 cells showed that both cHPMPC and HPMPC have comparable activities and cytotoxicities. cHPMPC was found to be stable on incubation in human plasma and human liver homogenates. Intracellular metabolism studies revealed that cHPMPC was converted inside of the cells to HPMPC and then to the monophosphate, the diphosphate, and the monophosphate choline metabolites. In a mouse herpes simplex virus type 2 encephalitis model, both cHPMPC and HPMPC exhibited similar potencies in vivo. Nephrotoxicity, which is the dose-limiting toxicity of HPMPC, was assessed in a 14-day repeated-dose toxicity study in rats; cHPMPC has an improved safety margin of > or = 13-fold over that of HPMPC.

Vitreous fluorophotometry in patients with crystalline retinopathy

Patients with various stages of crystalline retinopathy were examined with vitreous fluorophotometry and the results were compared with those of normal subjects. Two patients with glistening crystals without pigment clumps, together with atrophy of the retinal pigment epithelium in the posterior pole, showed a normal inward permeability of fluorescein. Three patients with a large area of choriocapillaris atrophy in the posterior pole, in addition to atrophy of retinal pigment epithelium, demonstrated an increase in the rate of inward fluorescein penetration. Three patients with extensive areas of choriocapillaris atrophy throughout the fundus also revealed an increased posterior vitreous penetration ratio.

Potential therapeutic recombinant proteins comprised of peptides containing recombined T cell epitopes

The complete primary structure of Fel d I2 has been determined and shown to be comprised of two separate polypeptide chains (designated chain 1 and 2). Overlapping peptides covering the entire sequence of both chains of Fel d I have been used to map the major areas of human T cell reactivity. The present study describes three non-contiguous T cell reactive regions of < 30 aa in length that were assembled in all six possible configurations using PCR and recombinant DNA methods. These six recombinant proteins comprised of defined non-contiguous T cell epitope regions artificially combined into single polypeptide chains have been expressed in E. coli, highly purified, and examined for their ability to bind to human cat-allergic IgE and for human T cell reactivity. Several of these recombined T cell epitope-containing polypeptides exhibit markedly reduced IgE binding as compared to the native Fel d I. Importantly, the human T cell reactivity to individual T cell epitope-containing regions is maintained even though each was placed in an unnatural position as compared to the native molecule. In addition, T cell responses to potential junctional epitopes were not detected. It was also demonstrated in mice that s.c. injection of T cell epitope-containing polypeptides inhibits the T cell response to the individual peptides upon subsequent challenge in vitro. Thus, these recombined T cell epitope-containing polypeptides, which harbor multiple T cell reactive regions but have significantly reduced reactivity with allergic human IgE, constitute a novel potential approach for desensitization to important allergens.

Behavioral and psychosocial cancer research in the underserved. An agenda for the future

BACKGROUND

This research was undertaken to review the status of behavioral and psychosocial cancer research in the underserved.

METHODS

The author extensively reviewed the literature related to behavioral and psychosocial cancer research in the underserved for this article. The author's experience as the Principal Investigator for the only National Institutes of Health smoking cessation study targeting Asian-Americans also was used in analyzing the literature and developing an agenda for the future.

RESULTS

Two questions and accompanying agenda items were addressed. The underserved were defined, and the effect of being underserved was illustrated through their disproportionate and earlier (younger) presence in morbidity and mortality statistics. Initiating behavioral and psychosocial cancer research in the underserved begins with a proper attitude and making accommodations to culture. The agenda for research should be practical and assessed on the basis of prevalence and preventability of cancer related behaviors. Examples from underserved Asian-American populations were cited.

CONCLUSIONS

Behavioral and psychosocial cancer research needs to be done.

An evaluation of heart health education for Southeast Asians

We present data on the effects of a heart health education intervention targeted at adult Southeast Asians. Within each of the Cambodian, Laotian, and Vietnamese groups who received the intervention, we obtained random samples approximately three to 18 months postintervention. Comparisons were made between preintervention and postintervention knowledge of blood pressure and awareness of behaviors to prevent heart disease. Within all three ethnic samples, we found significant increases in the pre-to-post percentages of individuals who could define blood pressure and identify ways to prevent heart diseases.

[Clinical factors affecting prognosis of small hepatocellular carcinoma after hepatectomy]

One hundred and two patients with histologically diagnosed small hepatocellular carcinoma (< or = 5cm HCC) underwent curative irregular hepatectomy in our hospital from Nov 1972 to Nov 1992. The postoperative survival rates at 1,3,5 and 10 years were 93.9%, 75.3%, 52.8% and 44.6%, respectively. We analysed the clinical factors using a Cox model and found that the clinical staging of HCC, gamma-GT, satellite tumor nodules, tumour capsule and postoperative recurrence have significant effect on the survival rate of patients. We conclude that early diagnosis of sub--clinical HCC, transarterial embolism after hepatectomy to reduce postoperative recurrence, and active treatment with operation and/or TAE after recurrence are effective methods to improve survival of HCC patients.

Surgical management of substernal goiter

Seventeen cases of large substernal goiter are reviewed. The commonest clinical features were frequent upper respiratory tract infections, dyspnea and a cervical mass. Five of the patients had previous thyroidectomy. The substernal goiter was located in the right chest in 11 cases, the left chest in five and bilaterally in one case. On computed tomograms it was pretracheal or prevascular in ten cases and retrovascular in seven. Tracheal deviation was present in 15 cases, causing tracheal compression or stenosis in 14. Thyroidectomy was performed on all 17 patients (8 subtotal, 9 total) through a low transverse collar incision. The recommended technique for substernal goiter extending from the neck to a level below the subcarinal region includes concomitant finger dissection and upward traction of the cervical thyroid through the subcapsular plane, with obliteration of the postresection substernal dead space by sutures. Follow-up radiography showed that all the deviated tracheas had resumed near normal position 2-3 months postoperatively and the average diameter of the compressed tracheas had increased significantly.

Adhesive Electroless Metallization of Fluoropolymeric Substrates

A process for producing patterned metal deposits on fluoropolymeric substrates is described. A metal ion-chelating organosilane is chemisorbed by self-assembly onto a fluoropolymer surface after radio-frequency glow discharge plasma surface hydroxylation. Positional modulation of the surface hydrophobicity is illustrated by wetting. The silane covalently binds an aqueous palladium catalyst and subsequent electroless deposition yields homogeneous or patterned metal deposits that exhibit excellent adhesion to the fluoropolymer.

Indocyanine green videoangiography of choroidal neovascular membrane in age-related macular degeneration

Fluorescein angiography is the traditional tool for the detection of choroidal neovascularization of age-related macular degeneration. However, some limitations exist which impede its efficacy in the detection of subretinal neovascularization. Indocyanine green videoangiography is a recently developed technique which differs from fluorescein angiography in many ways. We performed indocyanine green videoangiography in 18 eyes with occult choroidal neovascularization, demonstrated by fluorescein angiography. Sixteen of the 18 eyes showed an abnormal vessel loop in the early phase of indocyanine green videoangiography. In the late phase, all 18 eyes had abnormal dye retention around the suspected neovascular area; however, only 12 eyes revealed a distinct border of neovascularization. No side effects, such as nausea, vomiting, or allergic reactions, were noted in our patients. Advantages and drawbacks of indocyanine green videoangiography in comparison with fluorescein angiography are discussed.

An acculturation scale for Southeast Asians

This article reports the development of an acculturation scale for Southeast Asian immigrants. From factor analyses of responses on 13 items obtained from samples of three different Southeast Asian ethnic groups, i.e., Cambodians, Laotians, and Vietnamese, two subscales were derived: (1) proficiency in languages (land of origin versus English), and (2) language, social and food (LSF) preferences. Inter-item reliability of the scales was demonstrated for each of the three ethnic groups, with Cronbach alpha coefficients of 0.76 or above. Construct validity was also established within each of the three ethnic groups by demonstrating expected associations of the subscales with current age, years in the USA, total years of education, percentage of lifetime in the USA, and age on entering the USA. Multivariate analyses within each of the ethnic groups revealed that, once controlling for years of education, percentage of lifetime in the USA, and type of health care coverage, although not significant for the Cambodians (P = 0.08) males tended to show higher scores for the proficiency in language subscale in comparison to females. Similar multivariate analyses for the LSF preference subscale showed that although slightly higher for the males, the differences between the genders was not significant for the Cambodians (P = 0.78); both the Laotian (P = 0.23) and Vietnamese (P = 0.01) females showed higher scores in comparison to males although only just reaching significance for the Vietnamese.

Selective action of 4'-azidothymidine triphosphate on reverse transcriptase of human immunodeficiency virus type 1 and human DNA polymerases alpha and beta

4'-Azidothymidine (ADRT) is a novel nucleoside analogue that exhibits potent inhibitory activity against the replication of human immunodeficiency virus (HIV) in lymphocytes. The mechanisms by which ADRT inhibits HIV reverse transcriptase (HIV-RT) as ADRT 5'-triphosphate (ADRT-TP), the active intracellular metabolite of ADRT, and as the ADRT-MP molecule incorporated into DNA were examined and compared to their effects on human DNA polymerases alpha and beta. Inhibition of HIV-RT by ADRT-TP is competitive against TTP and is more potent against RNA to DNA synthesis (Ki = 0.009 microM versus Km = 3.3 microM for TTP) than it is against DNA to DNA synthesis (Ki = 0.95 microM versus Km = 16.3 microM for TTP). ADRT-TP is also a more potent inhibitor for primer elongation on RNA template than on DNA template. ADRT-TP is a poor inhibitor of human DNA polymerases alpha (Ki = 62.5 microM) and beta (Ki = 150 microM) (Chen et al., 1992). The consequences of ADRT incorporation into DNA are strikingly different for the HIV-RT and for human DNA polymerases alpha and beta. DNA polymerases alpha and beta incorporate a single ADRT-MP molecule into nascent DNA at a very slow rate and continue to elongate. They are unable to incorporate a second consecutive ADRT-MP. However, HIV-RT is able to efficiently incorporate two consecutive ADRT molecules. Incorporation of two consecutive ADRT-MP molecules by HIV-RT prevents further DNA chain elongation. Incorporation of two ADRT-MP molecules separated by one deoxyribonucleoside monophosphate (dAMP, dCMP, or dGMP) also abolishes DNA chain elongation by HIV-RT.

Glial growth factors are alternatively spliced erbB2 ligands expressed in the nervous system

Glial growth factors, proteins that are mitogenic for Schwann cells, and several ligands for the p185erbB2 receptor, are products of the same gene. Alternative splicing of the messenger RNA generates an array of putative membrane-attached, intracellular and secreted signalling proteins, at least some of which are expressed in the developing spinal cord and brain. These factors are probably important in the development and regeneration of the nervous system.

Cardiovascular health among Asian Americans/Pacific Islanders: an examination of health status and intervention approaches

PURPOSE OF THE REVIEW. The purpose of this review is to examine the cardiovascular health status of Asian Americans/Pacific Islanders by primary risk factor and review current intervention approaches targeting this population. Asian Americans/Pacific Islanders in the United States have experienced triple digit percentage increases in population for every decade since 1970. Despite their rapidly increasing numbers, little is known about their cardiovascular health status. SEARCH METHODS USED. This article reviews the literature on the demographics, mortality, and prevalence of major cardiovascular risk factors among Asian Americans/Pacific Islanders. Selected intervention programs are also described. SUMMARY OF IMPORTANT FINDINGS. Data on cardiovascular disease mortality for Asian Americans/Pacific Islanders are relatively limited because few states collect ethnically specific mortality statistics. Data on cardiovascular risk factors, particularly smoking and hypertension, for certain Asian American/Pacific Islander groups portend excessive cardiovascular disease burdens. MAJOR CONCLUSIONS. Data specific to ethnic groups comprising Asian Americans and Pacific Islanders need to be called. Also, scientifically valid and linguistically appropriate interventions approved by ethnic community leaders are needed to address Asian Americans/Pacific Islanders.

Development of macrovascular diseases in NIDDM patients in northern Taiwan. A 4-yr follow-up study

OBJECTIVE

To assess the development of macrovascular diseases and explore major associative factors in NIDDM.

RESEARCH DESIGN AND METHODS

A total of 479 NIDDM patients > or = 40 yr of age were recruited from four community primary care health centers of northern Taiwan in July 1986 for a cohort study with a 4-yr follow-up. No patient required insulin therapy within 1 yr of diagnosis nor had a history of diabetic ketoacidosis. All were able to participate independently in the activities of daily living. BP and ECG were measured, and a structured questionnaire was asked of each patient. Venous blood after overnight fasting was collected every year to measure cholesterol, HDL cholesterol, plasma glucose, and HbA1c.

RESULTS

The duration of diabetes was associated with the development of stroke with a relative risk of 1.063 for every 1-yr increment (P = 0.07). As for HVDs, the significant risk factors were serum cholesterol and HbA1c. For every 1-mg/dl increase in mean total cholesterol level, the relative risk of developing HVD increased 1.016-fold (P = 0.04). For every 1% increase in HbA1c, the relative risk of developing HVD increased 1.170-fold (P = 0.01). With regard to leg VDs, sex and cigarette smoking were significant risk factors. Women diabetic subjects had a higher relative risk than men. Cigarette smoking was significantly associated with leg VD with a relative risk of 6.9 for smokers compared with nonsmokers. The most significant risk factor for LVD was the total cholesterol level. For every 1-mg/dl increase in mean serum cholesterol level, the relative risk of LVD increased 1.013-fold.

CONCLUSIONS

In the prevention of macrovascular diseases, effective intervention of the nondiabetic cardiovascular risk factors may be as important as or even more important than the good control of diabetes.

Prevalence and risk factors of diabetic retinopathy among noninsulin-dependent diabetic subjects

In a population-based study in Taiwan, 11,478 subjects aged 40 years or older were screened for diabetes in one urban and five rural areas. Among the 715 subjects proven to have diabetes, 527 subjects underwent ophthalmoscopy. Diabetic retinopathy was present in 184 of the 527 subjects (35.0%), including background diabetic retinopathy in 157 subjects (30.0%), preproliferative diabetic retinopathy in 15 subjects (2.8%), and proliferative diabetic retinopathy in 12 subjects (2.2%). Diabetic retinopathy was correlated with the duration of diabetes and age at onset of diabetes, type of diabetes treatment, higher serum creatinine levels, and lower serum cholesterol levels. Several other factors, including gender, age, residential area, family income, educational level, control and family history of diabetes, body mass index, physical activity, exercise, cigarette smoking, stroke, ischemic heart disease, leg vessel disease, hypertension, and proteinuria, had no significant association with retinopathy. By multiple logistic regression analysis, duration of diabetes was the most important risk factor related to retinopathy. Diabetic subjects treated with insulin had a higher risk of developing retinopathy than those treated with dietary control (relative risk, 1.57; .05 < P < .10). The univariate analysis disclosed that proliferative diabetic retinopathy was related to older age at examination, older age at onset of diabetes, type of diabetes treatment, and presence of leg vessel disease. Insulin-treated diabetic subjects also had a higher risk of proliferative diabetic retinopathy than patients in whom diabetes was controlled by diet, with a relative risk of 2.51 (.05 < P < .10) in the multiple logistic regression analysis.

Developmental stage- and tissue-specific expression of shibire, a Drosophila gene involved in endocytosis

Dynamin, a microtubule-activated GTPase, has recently been identified as the product of the shibire gene in Drosophila. shi(ts) mutants are defective in synaptic vesicle recycling, which leads to rapid and reversible temperature-sensitive paralysis. In the present study, results from RNase protection assays and analysis of cDNA clones define a complex pattern of developmental- and tissue-specific alternative splicing at two sites within the coding region. This analysis is also supported by western blot analysis with two polyclonal antibodies. In situ hybridization data revealed a high concentration of shi transcripts in the central and peripheral nervous system throughout neuronal development. Other than the nervous system, shi transcripts are also expressed at a high level in early embryos, larval imaginal discs, and male and female gonads. These data provide a basis for interpreting the wide range of phenotypic effects of shi mutations in terms of the putative membrane-sorting properties of dynamin and for further functional study of different dynamin isoforms.

Human DNA polymerases alpha and beta are able to incorporate anti-HIV deoxynucleotides into DNA

Deoxynucleoside analogs, AZT and/or ddN, are the therapeutic agents currently utilized to inhibit the human immunodeficiency virus (HIV) reverse transcriptase. The effects of their anabolic products, AZT-triphosphate (AZT-TP) and ddCTP on human cellular DNA metabolic processes were studied using highly purified, structurally and enzymatically defined forms of the two major human host DNA polymerases, alpha and beta, and compared to those of the reverse transcriptase purified from HIV viron. Human DNA polymerase alpha during processive DNA synthesis is able to incorporate AZT-monophosphate (AZT-MP) but not ddCMP into DNA, causing chain termination. During its initial encounter with a primer terminus, polymerase alpha is able to incorporate both AZT-MP and ddCMP into DNA chains. Polymerase beta is able to incorporate AZT-MP and ddCMP into DNA, causing chain termination in both modes of DNA synthesis. Steady state kinetic analyses demonstrate that polymerase alpha inserts one AZT-MP molecule into DNA for every 2500 dTMP molecules incorporated. Polymerase beta incorporates ddCMP with efficiency nearly equal to that of dCMP. HIV reverse transcriptase prefers to incorporate AZT-MP and ddCMP rather than dTMP and dCMP, respectively. The findings described here raise the concern that the capability of the two major host DNA polymerases to incorporate AZT-MP or ddCMP into DNA might cause adverse side effects on human DNA metabolism and mutation in the genomes of patients under long term continuous treatment with AZT and ddC.

Prognosis of thymic carcinoma: analysis of 16 cases

Primary thymic carcinoma is a rare malignant neoplasm which arises from the thymic epithelium. Between May 1982 and September 1990, 16 patients with thymic carcinomas, diagnosed at Chang Gung Memorial Hospital, were reviewed. Their ages ranged from 19 to 75 years, with a median of 40 years. Males predominated (male to female ratio was 11:5). The most common presenting symptoms were chest pain, cough, body weight loss and dyspnea. No paraneoplastic syndromes were seen. Chest roentgenograms of 15 patients revealed a mediastinal mass, but a definitive diagnosis could not be made until surgery. Adjacent mediastinal tissues were invaded, or adhered to, by all the tumors. Six distinct histologic types were found, squamous cell carcinoma being the most common (seven cases). The primary treatment of surgical resection was attempted in 14 patients, but only in five cases could the tumors be completely resected; two had a biopsy only. Radiotherapy, with or without chemotherapy, given postoperatively, achieved additional local control in seven of the nine partially resected patients (77%). Distant metastasis occurred in nine of 16 patients (56%). Lymph nodes, bone and lung were the most common metastatic sites. Chemotherapy with cisplatin and/or adriamycin-based regimens was given to patients who had distant metastasis, but the responses were unsatisfactory. The overall survival at one, three and five years was 88%, 51% and 31%, respectively. The median survival was 30 months. The median survival of patients with pure squamous cell carcinoma (> 49 months) was superior to that of patients with other histologic types (18 months; p < 0.01).

Bilateral macular coloboma and pigmented paravenous retinochoroidal atrophy

A patient had bilateral macular coloboma with aggregations of pigment clumps located perivascularly, predominantly paravenously, and in other parts of the retina. The Toxoplasma IgG antibody was negative. The diagnosis of bilateral macular coloboma with pigmented paravenous retinochoroidal atrophy was made and seemed to be a developmental abnormality in origin.