Surgical treatment of bone tumors in conjunction with microwave-induced hyperthermia and adjuvant immunotherapy. A preliminary report

OBJECTIVE

To develop an alternative approach in conjunction with microwave-induced hyperthermia.

PATIENTS AND METHODS

Thermotherapy with microwave intracorporeal irradiation was used to treat 73 patients with bone tumors. The series was composed of 58 patients with malignant tumors and 15 with benign tumors: most of tumors occurred about knee joints (53/73 = 72.6%). The surgical procedure included separating the tumor bearing segment from surrounding normal tissues with a safe margin, cooling the normal tissues including the neurovascular bundle and the intraarticular structures with a water circulation system, while heating the tumor with the antenna array of a microwave system and providing an adequate soft-tissue cover for the dead bone. Postoperatively, an immune therapy regimen was carried out regularly. The patients' immunologic functions were monitored by assay of the subpopulation of T cells, IL-2 and sIL-2 R (soluble IL-2 receptor).

RESULTS

Follow-up varied from 3 to 38 months (mean 19 months). Excluding 3 patients with malignancy in the vertebrae treated for palliation, 70 were evaluated according to oncological and orthopedic criteria. Five patients had local recurrence and required amputation. The remaining 65 had excellent local control. In 6 of the 55 patients with malignancy of the extremities, lung metastasis occurred one to two years after surgery. The oncological results were similar to those obtained by other limb-saving procedures. Pathological fracture occurred at devitalized bone in 5 patients. In 72.5% of the patients (29 of 40 tumor-free cases followed more than one year), knee joints functioned well, being stable and painless with almost full range of motion. Single photon emission computered tomography (SPECT) for 16 patients revealed revascularization of the devitalized tumor bearing bone segment could accomplish in one year or more. The immune states were improved in various extends after thermotherapy plus immunotherapy in the majority of patients.

CONCLUSION

These results show that the use of microwave hyperthermia and adjuvant immunotherapy in conjunction with the surgical treatment of bone tumors can be considered a definitive procedure, which is safe and well-tolerated. The oncological and orthopedic results are encouraging.

Ingenane diterpenes from Euphorbia petiolata

From the whole plants of Euphorbia petiolata, four new ingenane-type diterpenoids, 3,20-O-diacetylingenol 5-O-(2' E,4' Z)-tetradecadienoate (1), 5,20-O-diacetylingenol 3- O-(2' E,4' Z)-tetradecadienoate (2), ingenol 3-O-(2' E,4' Z)-tetradecadienoate (3), and 5,20-O-isopropylidenylingenol 3-O-(2' E,4' Z)-tetradecadienoate (4) were isolated. Their structures were elucidated by spectroscopic methods and chemical transformations.

[Assay of contents of lysozyme, SIgA, IgA and IgG in tongue coating]

The contents of lysozyme, SIgA, IgA, and IgG in 98 cases with pathological tongue coating and 30 cases of normal coating were analysed by using the thorough random analysis of variance. The results showed that the content of lysozyme in pathological coating was lower than that in normals significantly (P < 0.0001), while the contents of SIgA, IgG in pathological coating were higher than that of normals (P < 0.0001). It indicates that immune reaction is very active during the development of pathological tongue coating.

[Variolation, pioneer of modern immunology]

Smallpox spread into China at the end of the Han Dynasty. Therapeutic remedies were first recorded in Ge Hong's Zhou Hou Jiu Zu Fang in the Jin Dynasty. It is possible that variolation made its first appearance in the Northern Song Dynasty. It can be sure that there was a variolation centre in Taiping County of Ningguo District in Anhui. The Kangxi Emperor of the Qing Dynasty advocated and encouraged the popularization of the art which was then spread outside China. Edward Jenner, the English physician who practised variolation, modified variolation into vaccination, which eventually lead to the formation of modern immunology and the declaration of eradication of smallpox on the Earth by WHO in 1980. The article describes the historical process of variolation to vaccination and points out that the modified variolation was safe and reliable. Unfortunately, the westerners only followed the simple smallpox-juice method which was relatively more dangerous.

[A study on the degradation kinetics of nicotinamide powder]

The effect of temperature and humidity on the degradation of nicotinamide powder was studied below the critical relative humidity at temperatures 50-80 degrees C and relative humidities 50-80%. The rate equation of the degradation of nicotinamide under isothermal and constant humidity conditions is -dC/dt=k(Co-C)-1, where k is the apparent rate constant of degradation, Co and C are initial concentration and concentration at time t of nicotinamide, respectively. The relationship between the apparent rate constant of degradation and relative humidity RH is in K=a + m (RH), where a and m are constants. When RH are 50.35, 66.85, 75.33 and 80.35%, the apparent activation energies of degradation from Arrhenius equation are 219.94, 181.86, 168.99 and 153.89 kJ/mol, respectively. The rate equation the photodegradation of nicotinamide under room temperature is -dR/dt=K' (Ro-R)-1, where K' is the apparent rate constant of photodegradation, Ro and R are initial reflectance and reflectance at time t of nicotinamide, respectively.

[Chemical constituents of Actinidia kolomikta (Rupr. et Maxim.) Planch]

Two crystalline components I and II were isolated from the roots of Actinidia kolomikta. I was identified as delta 7-stigmasterol and II was named alpha-kolomiktriose and elucidated as 2, 3-di-0-beta-D-galactopyranosyl-alpha-D-galactopyranose on the basis of spectral data (13C NMR, 1H NMR, IR and EI-MS).

Serodiagnosis of Lyme borreliosis by western immunoblot: reactivity of various significant antibodies against Borrelia burgdorferi

The significance of various antibodies against Borrelia burgdorferi was studied by Western blot (immunoblot) by using 578 human serum samples. The proteins regularly detected by using samples from patients with Lyme borreliosis were those with bands with molecular masses of 94, 83, 75, 66, 60, 55, 46, 41, 39, 34, 31, 29, 22, and 17 kDa. The detectable frequencies of most of these proteins appeared to be significantly different between the sera from patients with Lyme borreliosis and those from normal control individuals as well as from the group with syphilis. The 39-kDa protein band recognized by polyvalent antibody was found to be the most significant marker for Lyme borreliosis. Furthermore, an anti-39-kDa immunoglobulin M response was detected in the samples from patients with early-stage Lyme borreliosis. Results from the use of monoclonal antibodies and patient sera revealed that the 39- and 41-kDa proteins may be structurally related but are immunologically distinct antigens. The significance of antibody reactivities to the 41-, 94-, 22-, 31-, and 34-kDa protein bands is also discussed.

Trends in basal cell carcinoma, squamous cell carcinoma, and melanoma of the skin from 1973 through 1987

Major increases have occurred in the incidence of basal cell carcinoma and squamous cell carcinoma of the skin, as well as in cutaneous malignant melanoma during the period 1973 through 1987 in British Columbia. The greatest increases in basal and squamous cell carcinomas are on the head and neck. This indicates that exposure to sunlight is the major causative factor. The greatest increase in melanoma is on the trunk in men and on the lower limbs in women. The dramatic increases in nonmelanoma skin cancers in British Columbia, a relatively low sunlight area, suggest that major prevention programs are needed in areas that are not considered "sunspots."

Automated, fully computerized analysis of the clinical electroretinogram

Being a relatively simply composed bioelectric signal, the ERG lends itself very well to computer analysis. This paper presents the results obtained by the employment of an automated, fully computerized ERG analysis system. It is concluded that programmable computing facilities have the effect of rendering diagnostic ERG evaluation more accurate and reliable as well as saving a lot of human effort.