Quantitative myasthenia gravis score: assessment of responsiveness and longitudinal validity

We prospectively tested the quantitative myasthenia gravis score (QMG) for responsiveness and longitudinal construct validity in 53 patients with myasthenia gravis. Index of responsiveness was high. Longitudinal construct validity was confirmed by the correlation between changes in QMG and manual muscle testing and by a difference in QMG changes across patients that were clinically unchanged, improved, or worse between two visits. Our results support QMG use for assessing clinical change in trials.

Adjuvant therapy of stage II breast cancer treated with CMFVP, radiation therapy and VATH following lumpectomy. A pilot trial

A pilot study was undertaken to assess the feasibility, toxicity, and efficacy of combined radiation therapy and chemotherapy in the adjuvant treatment of node-positive. Stage II patients with breast carcinoma who had undergone lumpectomy. Therapy consisted of three phases, starting with a six-week CMFVP (cyclophosphamide, methotrexate, 5-fluorouracil, vincristine, prednisone) induction, followed by radiation therapy to the breast, and concluding with four cycles of VATH (vinblastine, Adriamycin, thiotepa, Halotesin). Twenty-seven patients were entered with an average age of 51.5 years (median 50 yrs) and a mean follow-up of 46.2 months. Twenty-three patients (85.2%) are alive and 19 (70.3%) disease free. There were no ipsilateral local recurrences. Cosmetic results were good to excellent in 26/27 patients. The doses of VATH were not compromised by the prior therapy. The regimen was found to be tolerable and is a reasonable approach in the adjuvant treatment of this particular patient population.

Recurrent oncocytoma of the ethmoid sinus with orbital invasion

A patient is presented with recurrent oncocytic tumor that arose from the lateral nasal wall and posterior ethmoid sinus and then invaded the orbit. The diagnosis of an oncocytic lesion was made from the masses of intracellular mitochondria noted on electron microscopy. The malignant character of the tumor was evident from its local aggressiveness. In agreement with earlier authors, we believe that oncocytic tumors of the nose and paranasal sinuses should be classified as low-grade malignancies.