bluuebunny/crossref_metadata_2025 huggingface dataset:
Nondisjunction induced in mouse spermatogenesis by chloral hydrate, a metabolite of trichloroethylene
Authors: Russo Antonella , Pacchierotti Francesca , Metalli Pietro
Published: February 2007

The effects of chloral hydrate (CH), an in vivo metabolite of trichloroethylene, have been evaluated by cytogenetic observations of mouse secondary spermatocytes after ip treatment with 82.7, 165.4, or 413.5 mg/kg bw. Hyper‐haploid metaphases have been scored to determine whether previous observations in various nonmammalian organisms about an effect of this drug on the mitotic spindle could be confirmed in mice.

At each dose, the frequencies of hyper‐haploid cells have been estimated to assess the response of pachytene, preleptotene, premeiotic, and staminal gonial cells. Significant increases above the control value have been observed particularly after treatment of actively dividing gonial cells, confirming the results obtained with the same batch of the drug in a parallel collaborative investigation with Aspergillus nidulans.

Thus: a) chloral hydrate has been shown to be effective in inducing nondisjunction in a mammalian system; b) a prevalent action on the mitotic spindle has been confirmed and quantified; and c) the usefulness of parallel investigations with different methods is stressed, particularly to collect information about the mechanisms of induction of nondisjunction events.
Structural features of nitroaromatics that determine mutagenic activity in salmonella typhimurium
Authors: Vance William A. , Levin David E.
Published: February 2007

Seventeen structurally homologous nitroaromatics were tested for direct‐acting mutagenic potency in nine strains of Salmonella typhimurium. The following four structural features were determined to have a strong influence on mutagenic activity: physical dimensions of the aromatic rings, isomeric position of the nitro group, conformation of the nitro group with respect to the plane of the aromatic rings, and ability to resonance‐stabilize the ultimate electrophile. Progressive addition of five‐ and six‐membered rings to a nitrobenzene nucleus demonstrated that mutagenic activity was a direct function of size. Fluoranthene was of optimal size (four rings) for mutagenicity; an additional benzene ring, giving benzo[k]fluoranthene, reduced mutagenic activity. Nitroaromatics with a nitro group oriented along the long axis of symmetry of the molecule were more potent mutagens than those with the nitro group oriented along the short axis. These results are discussed in light of the insertion‐denaturation model for intercalation of certain DNA adducts. Nitroaromatics with nitro groups sterically forced out of the plane of the aromatic rings were weakly mutagenic or nonmutagenic. Nitro groups located between two peri hydrogens or in a bay‐region are examples of this conformation. Finally, structural features that contribute to resonance stabilization of the reactive nitrenium ion enhance mutagenic potency. Thus, 6‐nitroindene was at least tenfold more mutagenic than 5‐nitroindene. These positional isomers are structurally identical with the exception of the position of an olefinic bond in the adjacent five‐membered ring which can contribute to resonance stabilization of a carbonium ion formed after bioactivation of 6‐nitroindene but not of 5‐nitroindene. The predictive value of these structure‐activity relationships should permit a first approximation in the assessment of mutagenic potency of nitroaromatics.
Review: Putative mutagens and carcinogens in foods. VI. Protein pyrolysate products
Authors: Vuolo Loretta L. , Schuessler Glenn J.
Published: February 2007

Diet and nutrition may be responsible for 60% of the total cancer incidence for women and greater than 40% for men. Fat, animal protein, and meat consumption are highly correlated with colon cancer incidence. The charcoal broiling of meat and fish yield mutagenic substances. Many findings support the hypothesis that the predominant mutagens are formed by the Maillard reaction. A number of mutagenic compounds have been identified both from cooked foods and from protein pyrolysates. The identified compounds are N‐heterocyclic primary amine derivatives of either carbolines, imidazoquinolines, or imidazoquinoxalines. The carboline‐type mutagens are structurally related to the known carcinogens 2‐acetylaminofluorene (AAF) and 2‐aminofluorene (AF), while the imidazoquinoline and imidazoquinoxaline types are believed to resemble 3,2′‐dimethyl‐4‐aminobiphenyl (DMAB). Studies support the theory that these compounds require metabolic activation and are carcinogenic. The major metabolites of several compounds have been identified as the N‐hydroxy derivatives. DNA binding was found to be a necessary but not a sufficient condition for mutagenesis. The modified base products have been identified as C‐8‐guanyl derivatives, resembling adducts formed by the carcinogenic aromatic amines.
Metabolism and mutagenicity of acrylonitrile: An in vivo study
Authors: Lambotte‐Vandepaer M. , Duverger‐van Bogaert M. , Rollmann B.
Published: February 2007

The mutagenic activity present in urine of animals treated with acrylonitrile (ACN) is tentatively related to the excretion of three urinary metabolites: thiocyanate (SCN−), hydroxyethylmercapturic acid (OH‐MA), and cyanoethylmercapturic acid (CN‐MA). It is shown that the route of administration and animal species affect SCN− excretion but not the excretion of hydroxyethyl‐ and cyanoethylmercapturic acids or the mutagenicity of urine from ACN‐treated animals. Various pretreatments (phenobarbital, CoCl2, diethylmaleate, trichloroacetonitrile) decrease the mutagenicity of urine from ACN‐treated animals and decrease the excretion of SCN− and OH‐MA. None of the quantified urinary metabolites is responsible for urinary mutagenicity.
Measurement of unscheduled DNA synthesis in rat kidney cells following in vivo treatment with genotoxic agents
Authors: Tyson C. Kimerly , Mirsalis Jon C.
Published: February 2007

The kidney is a key target tissue in animal and human carcinogenesis, yet there are no established short‐term tests for studying the genotoxicity of chemicals in the kidney. We have developed an assay for the measurement of chemically induced DNA repair as unscheduled DNA synthesis (UDS) in isolated rat kidney cells following in vivo treatment. Male Fischer‐344 rats were injected intraperitoneally with chemicals dissolved in saline or corn oil. After various treatment times, the kidneys were perfused with a collagenase/trypsin solution (CTS), minced into small pieces, and stirred in CTS at 37°C for 1 hr to dissociate cells. Cultures contain a high proportion of epithelial cells from the proximal and distal tubules. Cultures were incubated for 16–18 hr with 3H‐thymidine in Williams' Medium E supplemented with 20% fetal bovine serum. UDS was measured by quantitative autoradiography as net grains/nucleus (NG). The percentage of cells in repair (% IR) was defined as the percentage of cells with ⩾ 3 NG. Saline‐ or corn oil‐injected controls consistently produced −3 to −5 NG with < 1 % IR. The time course of DNA repair following treatment with the direct‐acting mutagen methylmethane sulfonate (MMS) or the renal carcinogen azaserine showed a peak response at 2 hr after treatment. Azaserine showed a rapid decline in UDS at 12 and 24 hr, whereas MMS exhibited a relatively high UDS level at 24 hr. The renal carcinogens methylazoxymethanol acetate, N‐methyl‐N‐nitrosourea, and streptozotocin all yielded strong positive UDS responses. The liver and intestinal carcinogen 1, 1‐dimethylhydrazine at doses up to 50 mg/kg was cytotoxic to kidney cells, but induced < 0 NG. Treatment with 1,2‐dimethylhydrazine, which induces kidney tumors in mice but not rats, also induced < 0 NG. Treatment with o‐anisidine, a weak renal carcinogen, did not induce UDS in the kidney, suggesting that it may be acting as a tumor promotor. These results demonstrate the usefulness of this assay for the detection and study of a variety of genotoxic kidney carcinogens.
Strategies to reduce the cost of mutagenicity screening with the Salmonella assay
Authors: Zeiger Errol , Risko Kenneth J. , Margolin Barry H.
Published: February 2007

An extensive Salmonella assay database was analyzed in order to develop strategies to reduce costs of screening chemicals for mutagenicity. This database was obtained from testing 941 samples (representing 799 chemicals), 36% of which were judged mutagenic. Strains TA98, TA100, TA1535, and TA1537 without activation, with rat liver S‐9, and with hamster liver S‐9, make up the 12 strain/ activation combinations considered here. The testing strategies examined consist of two or three stages; a positive result at any stage is regarded as definitive and stops the testing. Sequential testing improves efficiency by eliminating the need for further experimentation once a chemical has been found to be mutagenic. Consequently, costs and effort are reduced. For screening chemicals in the Salmonella assay, it is our recommendation that a sequential testing scheme be adopted whose initial stage consists of TA 100.
Micronuclei in red blood cells of the newt pleurodeles waltl after treatment with benzo(a)pyrene: Dependence on dose, length of exposure, posttreatment time, and uptake of the drug
Authors: Grinfeld S. , Jaylet A. , Siboulet R. , Deparis P. , Chouroulinkov I.
Published: February 2007

Aquatic larvae of the newt Pleurodeles waltl were exposed to different concentrations of benzo(a)pyrene (BaP) for various lengths of time. Frequencies of micronuclei in circulating erythrocytes were determined at different times after termination of the treatment. The incidence of micronuclei in larvae kept for 8 days in BaP‐containing water displayed a marked increase with dose up to 0.075 ppm and a more gradual one with higher doses, reaching 158 per 1,000 at 0.75 ppm. The lowest dose at which a significant increase could be discerned was 0.01 ppm. Short periods of exposure, less than 2 days, did not result in a marked increase in micronuclei. Uptake and release was studied with tritiated BaP. Larvae concentrated BaP rapidly, attaining maximal levels after 12 hr. The ratio of radioactivity in larvae to that in an equivalent volume of surrounding water was about 200 independent of the amount of BaP added. Calf serum or bovine serum albumin added to the water lowered this ratio by competing for binding to BaP. Radioactive larvae placed in regularly renewed noncontaminated water lost 99% of the label after 100 hr. It is concluded that pleurodele larvae are a promising model for the detection of genotoxic activity in the aquatic environment.
Electronic considerations in the mutagenesis of some 4,5‐bridged chrysenes
Authors: Lee‐Ruff E. , Raj A. S. , Kruk H. , Katz M.
Published: February 2007

The mutagenic activity of four 4,5‐bridged chrysene derivatives, benz(a)aceanthrylene, and 5‐methylchrysene was examined using histidine auxotrophic strains TA98 and TA100 of Salmonella typhimurium. All compounds showed a positive mutagenic response with both TA100 and TA98 in the presence of S‐9. A correlation between the electronic character of the bridging group and mutagenic activity for the chrysene derivatives is proposed.
Skin‐graft reconstruction in carcinoma of the tongue
Authors: McGregor Ian A. , McGrouther Duncan A.
Published: February 2007

The use of quilted grafts in the treatment of minimally infiltrative carcinoma of the tongue is described. Results are assessed in terms of therapeutic effectiveness and functional adequacy. This single‐stage graft procedure is compared to multistage flap reconstruction as well as to direct suture. We conclude that, with careful selection of patients, the method is a satisfactory one.
Permanent control of massive tumor bleeding with intraluminal balloon catheters
Authors: Prian Gregory W. , Pearlman N. W.
Published: February 2007

Proximal ligation usually controls bleeding from a tumor‐eroded carotid artery. When this maneuver failed, two intraluminal balloon catheters were passed distally into the vessel, after which they were inflated and left in place for six weeks. The patient had no neurologic sequelae or further bleeding before succumbing to tumor progression 10 months later.
The suboccipital approach to removal of acoustic neuromas
Authors: Rhoton Albert L.
Published: February 2007

This article reviews the author's technique for removing acoustic neuromas by the suboccipital approach. Also discussed are various considerations regarding the selection and use of instruments for this operation. The anatomy of the internal acoustic meatus and the principles involved in facial‐ and cochlear‐nerve preservation are described. A guide is provided for stepwise dissection of the internal acoustic meatus in the laboratory.
Therapeutic embolization of the carotid arteries: A review
Authors: Moseley Ivan
Published: February 2007

Therapeutic embolization is now used widely for the treatment, either definitive or preoperative, of vascular lesions within areas supplied by the carotid arteries. Its place in the treatment of arteriovenous fistulas, malformations, and vascular tumors fed largely by the external carotid artery is established, although some of the newer embolic materials have not been fully proven. Balloon catheters appear to represent an important method for treating internal carotidcavernous sinus and similar fistulas. Embolization of cerebral lesions is still practiced on a much smaller scale, and questions as to its efficacy and safety have not been resoived.
Embolization techniques in vascular tumors of the head and neck
Authors: Thompson James N. , Fierstein Stephen B. , Kohut Robert I.
Published: February 2007

Surgical excisions of vascular tumors of the head and neck are frequently associated with difficulties because of the potential of operative blood loss. The technique of selective percutaneous embolization before surgery has emerged as a valuable adjunct—and even alternative—to surgery in the management of such lesions. By reducing the blood flow to a vascular tumor or arteriovenous malformation, embolization techniques can greatly facilitate surgical excision. The participation of a qualified invasive radiologist is essential. If cases are carefully selected and procedural details strictly adhered to, this technique can be quite valuable to surgeons treating vascular lesions of the head and neck.
Value and limits of computer‐assisted tomography
Authors: Schindler Erwin , Reck Ralf
Published: February 2007

Three years ago, at the VIIth International Congress of Radiology in Otorhinolaryngology, held in Copenhagen, the early impressive results of computer‐assisted tomography (CAT) in otorhinolaryngology were presented. Since considerable technologic and diagnostic progress of CAT has taken place in the meantime, questions about the increase in CAT's value and the expansion of its limits are appropriate now. Computed and, in some cases, conventional tomograms of facial lesions are used in the discussion of these questions. There is no doubt of CAT's advance within the last few years; there are, however, limits of CAT to be emphasized: (a) coronal CAT might be uncomfortable (especially if the gantry cannot be tilted), unsuccessful (e.g., in cases of neck stiffness), and even dangerous (when head injury is combined with trauma to the cervical spine); (b) enhancement is often not useful (except when intracranial tumor invasion is suspected); (c) specific diagnosis, based on CAT findings only, is impossible in most cases; (d) the radiation dose, which increases with improvement in the quality of the image, must be considered in each case; and (e) CAT does not replace conventional x‐ray techniques, least of all polytomography.
Computer‐assisted tomography: Sinus lesions with orbital involvement
Authors: Bilaniuk Larissa T. , Zimmerman Robert A.
Published: February 2007

Computer‐assisted tomography (CAT) is superior to other roentgenographic modalities in evaluation of paranasal sinus lesions whenever extension into the orbit is suspected. CAT not only demonstrates the orbital involvement, its location, and extent, but also the nature of the sinus lesion. Conclusions based on 43 cases of paranasal sinus lesions with orbital involvement are presented. The entities include sinusitis with orbital cellulitis, mucocele, polyposis, ossifying fibroma, fibrous dysplasia, cylindroma, osteoblastoma, lymphoma, carcinoma, and rhabdomyosarcoma.
Bilateral Z‐flap pharyngoplasty in the treatment of rhinolalia
Authors: Meyer Rodolphe , Failat Abdul S. Abul , Kelly Thomas P.
Published: February 2007

A technique using a bilateral Z‐flap pharyngoplasty in the treatment of rhinolalia is reviewed. Also reviewed is the historical development of the surgical treatment of rhinolalia. Sixteen patients with rhinolalia and 3 patients with pharyngitis sicca who were treated by this technique have been followed for up to 16 years, and have shown marked improvement in speech.
Experiences with the deltopectoral flap in reconstructive surgery of the head and neck
Authors: Tiwari Ram M. , Gorter H. , Snow Gordon B.
Published: February 2007

Despite the development of many alternative methods of reconstruction in head and neck surgery, the deltopectoral skin flap still remains a useful method in our armamentarium. Its use as a nondelayed procedure in 44 patients with various defects in the head and neck following tumor surgery is discussed. The reliability of the deltopectoral flap is evaluated. Major necrosis of the flap occurred in 6 (13.6%) of our patients. As to the cause of failure, more than one factor could be identified in the individual patient. However, the failure rate was higher when the flap was used in the reconstruction of defects in the anterior part of the oral cavity, particularly the floor of the mouth, than at other sites in the head and neck.
Surgical management of carcinoma of the posterior pharyngeal wall
Authors: McNeill Roger
Published: February 2007

Carcinoma of the posterior pharyngeal wall is an aggressive disease that demands vigorous therapy, often in the form of combined surgery and radiotherapy. Surgical excision of wide areas of the posterior pharyngeal wall may allow acceptable swallowing function in many patients. This article reviews the methods of surgical exposure utilized in conservation pharyngeal surgery and emphasizes the important principles involved in the preservation of laryngeal and pharyngeal functions.
Advances in head and neck surgery in children
Authors: Cotton Robin T. , Richardson Mark A.
Published: February 2007

Advances in pediatric head and neck surgery in the past decade have been on broad fronts. The laser coupled with the microscope has become an invaluable tool in the management of laryngeal pathologic entities such as papilloma, cysts, hemangiomas, and granulation tissue secondary to endotracheal tube damage. Its use in the management of choanal stenosis is increasing. Improvements in radiation and combination chemotherapy have spectacularly increased the survival rates in rhabdomyosarcoma. Newer surgical procedures for correction of drooling are obtaining good results. Reconstructions of extensive laryngotracheal stenoses in children are being performed with considerable success. Better techniques are available for revision surgery of defects remaining after primary palatoplasty.
Reconstruction of the lower lip
Authors: Wilson J. S. P. , Walker E. P.
Published: February 2007

Carcinoma of the lip arises in the strip of exposed mucosa between the mucocutaneous junction and the point of contact of the lips. Removal of the entire area at risk usually prevents recurrence or the development of a second primary tumor. A classification of lower lip involvement is presented, the various modes of treatment are reviewed, and surgical techniques for providing a pouting lower lip vermilion are described.
Combination chemotherapy for advanced squamous cell carcinoma of the head and neck
Authors: Coker Donald D. , Elias E. George , Chretien Paul B. , Gray William C. , Coleman John J. , Zentai Theresa A. , Didolkar Mukund S. , Morris Don M. , Viravathana Thavinsakdi , Hebel John R.
Published: February 2007

Fifty‐one patients (32 previously untreated, 19 previously treated) with advanced squamous cell carcinoma of the head and neck received a single course of combination chemotherapy consisting of high dose cis‐platinum (DDP), bleomycin (Bleo), ± high dose methotrexate (MTX). Thirty‐three (65%) patients responded to therapy; 5 (10%) of these patients had a complete response. Previously untreated patients and those who received the three drugs (DDP, Bleo and MTX) had the highest response rates. The duration of response was 8 to 12 weeks. Seven (15%) patients showed a two‐year survival rate. All nonresponders were dead of disease within two years. Three (56%) of the five complete‐response patients and 4 (21%) of the partial‐response patients survived for two years. The role of preoperative chemotherapy in head and neck cancer is yet to be conclusively defined.
Nuclear medicine in diagnosis and treatment of diseases of the head and neck: II
Authors: Blahd William H. , Rose Judith G.
Published: February 2007

The advent of both improved imaging systems and new radioactive agents has increased the effectiveness of nuclear medicine in diagnosing and treating diseases of the head and neck. In this second of two articles, we discuss radionuclide bone imaging and the role of nuclear medicine in the management of thyroid disease. Radionuclide bone imaging is useful in the differential diagnosis of sinusitis, the early detection of head and neck fracture, the assessment of temporomandibular joint disease, and the identification of local extension of primary head and neck carcinoma. In the management of thyroid disease, radionuclide technology is uniquely helpful in the diagnostic evaluation of the thyroid nodule and radioactive iodine continues to play a major role in thyroid cancer therapy.
Osteosarcoma of the nasal bone in a child
Authors: Singh Jagdev , Gluckman Jack L. , Kaufman Robert A. , Wakely Paul E.
Published: February 2007

Osteosarcoma commonly arises in the metaphyses of the long bones and rarely appears in other parts of the long bones or in flat bones. In the head and neck, 6.5% of all osteosarcomas occur in the jaws. A very rare case is presented in which an osteosarcoma developed in the nasal bones of a 4‐year 9‐month‐old girl without any predisposing cause. The literature pertaining to osteosarcomas of the head and neck, particularly in children, also is reviewed.
Paranasal sinus radiology, Part IA: Introduction and the frontal sinuses
Authors: Dolan Kenneth D.
Published: February 2007

The radiologic techniques of plain film roentgenography, tomography, and computerized tomography are important supplements to patient history and physical examination in the diagnosis of diseases of the paranasal sinuses. Background historical information regarding these radiologic modalities is presented, and the development and anatomy of the sinuses and roentgenographic views are discussed. The development and anatomy of the frontal sinuses are discussed, and inflammatory disease of the frontal sinuses as it appears in various roentgenographic modalities is described and illustrated.
Paranasal sinus radiology, part 2B: Ethmoidal sinuses
Authors: Dolan Kenneth D.
Published: February 2007

The clinician must have a high level of suspicion in order to detect ethmoidal sinus disease. Survey plain film radiographic examination may provide information about gross changes in ethmoidal sinus transparency and the sinus walls. Conventional tomographic study will often aid evaluation of the ethmoidal sinus walls which may be obscured by overlying structures on plain films. Computerized tomography adds a new dimension to ethmoidal sinus study. By revealing not only bone changes but soft‐tissue abnormality as well, more complete understanding of the disease process is gained. Computerized tomography is particularly useful in evaluating orbital structural change due to ethmoidal sinus abnormality.
Olfactory neuroblastoma: A retrospective clinicopathologic study
Authors: Appelblatt Nancy Haley , McClatchey Kenneth D.
Published: February 2007

Twenty‐one cases of olfactory neuroblastoma treated at The University of Michigan Hospitals between 1945 and 1981 were reviewed with emphasis on the method of treatment and outcome. Staging of the cases by the method of Kadish and co‐workers was done. The clinical course was not predictable on the basis of the histologic criteria. Local recurrences were common (61%). Metastatic spread of the neoplasms occurred in 28% of the cases. The recurrence‐free interval decreased in those patients treated initially with radiation as compared with those treated with surgery alone. This study does not support the premise that radiation treatment is as good as surgery in early disease. Craniofacial resection combined with radiation treatment for recurrence is the preferred treatment.
Paranasal sinus radiology, part 3A: Sphenoidal sinus
Authors: Dolan Kenneth D.
Published: February 2007

This article describes the complex anatomy of the sphenoid bone. The development and size of the sphenoidal sinuses are quite variable and complete analysis of the sinus walls requires several views. The essential plain film projections and use of tomography and CT scans are described. Sphenoidal sinus inflammatory disease produces changes similar to those already discussed in the articles in this series on the frontal sinus and the ethmoidal sinus. Illustrations of sphenoidal sinus inflammatory disease are provided.
Rapid percutaneous cervical esophagostomy
Authors: Macht Steven D. , Fisher Jack
Published: February 2007

Our technique of percutaneously inserting a No. 16 gauge long Bard Angiocath when performing a cervical esophagostomy is described. This has been a safe and rapid technique, and its only disadvantage is the inability to adequately suction the stomach immediately after the procedure.
The management of hemangiomas of the eyelid and orbit
Authors: Pasyk Krystyna A. , Dingman Reed O. , Argenta Louis C. , Sandall Gary S.
Published: February 2007

The growth of hemangiomas of the orbital region varies greatly; it is unpredictable. Most lesions never reach sufficient size to impair vision; a few, however, may grow sufficiently to cause disastrous complications. Nine children with complete or partial occlusion of the vision by hemangioma of one eye are reported. (Functional vision was preserved only in those patients who had early subtotal excision of the eyelid hemangioma.) Two children with complete occlusion developed amblyopia in the involved eye. One had optic nerve atrophy. One of the four children with partial occlusion of vision had a permanent decrease in visual acuity. Of the remaining three children with normal vision, two had been operatively treated early, and one had unusually rapid involution of the hemangioma. We recommend that when a child has complete or partial visual occlusion due to hemangioma, subtotal or total excision of the hemangioma should be carried out within 1 week of the onset of visual occlusion to prevent amblyopia.
A new instrument: The goiter extractor
Authors: Sacre Robert
Published: February 2007

In order to simplify the extraction of large intrathoracic goiters and to avoid dramatic surgical problems, the author developed a simple instrument to extract goitric masses. The extractor was used 17 times (approximately 10% of the thyroidectomy procedures performed during 3 years). Its effectiveness was proven in 16 cases.
A study of whole organ cancerous larynges to determine resectability by conservation surgery
Authors: Robbins K. Thomas , Michaels Leslie
Published: February 2007

Sixty‐two extirpated whole larynges containing squamous cell carcinoma were examined by a transverse slicing method to determine whether a partial laryngeal resection would have been feasible. The epithelial origin and sites of invasion of each tumor were recorded. The observations suggested that in one third of the specimens conservation laryngeal surgery could have achieved complete removal of the cancer.
Permanent tracheostomy
Authors: Eliachar Isaac , Zohar Shmuel , Golz Avishai , Joachims Henry‐Zvi , Goldsher Moshe
Published: February 2007

A technique designed to create a permanent, wide open, and stable tracheal stoma is based on two corresponding U‐shaped flaps: one from the anterior tracheal wall, the other from the skin in the suprasternal notch. The method described in this article has proved to be efficient, practical, well tolerated, and readily reversible. Its applications when indicated may reduce the side effects and complications associated with tracheostomy. Our clinical experience with this technique covers eight patients who tolerated the procedure well. The follow‐up period exceeds 2 years.
Internal jugular phlebectasia
Authors: Matsuba Howard M. , Thawley Stanley E. , Smith Peter G.
Published: February 2007

Internal jugular phlebectasia or abnormal fusiform dilatation of the jugular venous system usually presents as a neck mass that increases in size with maneuvers, which increase intrathoracic pressure. We present a case of internal jugular phlebectasia in which, due to an atypical presentation, the diagnosis was confirmed only by surgical exploration. The pathophysiology and radiologic evaluation are discussed to determine the role reserved for surgery in the management of this entity.
Pain in the head and neck cancer patient: Changes over treatment
Authors: Keefe Francis J. , Manuel Gerdenio , Brantley Alton , Crisson James
Published: February 2007

The incidence, severity, and location of pain was evaluated in 30 head and neck cancer patients prior to treatment after the first phase of their treatment and upon the completion of treatment. The incidence of pain was relatively high (40%–70%) and tended to increase slightly over treatment. Patients having advanced disease (stage III or IV) had a higher incidence of pain. Pain severity ratings were stable over treatment. Pain was located close to tumor or incision sites, and a trend for patients to report a greater number of pain sites over treatment was noted. While medical status variables (disease stage and site) were found to predict pain status after the initial phase of cancer treatment, initial pain measurements were more likely to predict pain status at the completion of treatment.
Total Synthesis of a Natural Cerebroside from Euphorbiaceae
Authors: Cateni Francesca , Zacchigna Marina , Zilic Jelena , Di Luca Gabriella
Published: February 2007

The regioselective total synthesis of the natural cerebroside (2R,15Z)‐N‐{(1S,2S,3R,4R,5Z)‐1‐[(β‐D‐glucopyranosyloxy)methyl]‐2,3,4‐trihydroxyheptadec‐5‐en‐1‐yl}‐2‐hydroxytetracos‐15‐enamide (2), originally isolated from Euphorbiaceae, is reported in full detail.
Chemotherapy as definitive treatment of stage I‐II large cell and diffuse mixed lymphomas
Authors: Cabanillas Fernando
Published: February 2007

Combination chemotherapy with adriamycin‐containing regimens is effective in the management of advanced lymphomas. In view of this, we treated 43 patients with clinical stage I‐II large cell or diffuse mixed lymphoma with chemotherapy. Routine staging laparotomies were not done and radiotherapy was not used in these patients. The CR rate for the combined stage I‐II presentations is 90%. Of 11 patients with stage I presentations, only one has relapsed (at 64 months), and he expired 11 months after the recurrence. Of the 28 patients with stage II presentations who achieved a CR, seven have relapsed but three of these have achieved a second CR and remain in remission. Late relapses were common in this group of stage I‐II presentations. Four of eight relapses occurring in patients who achieved disease‐free status took place > 24 months after initiation of therapy. Chemotherapy alone appears to be adequate for treatment of stage I large cell lymphoma, although larger numbers of patients might be required to definitely make this conclusion. Close to 2/3 of patients with stage II presentations appear to have been cured with the use of chemotherapy alone. The failures occurred mostly in those with bulky disease. It is possible that radiotherapy given after chemotherapy could consolidate these bulky areas of disease and thus prevent local relapses.
The role of radiation therapy in the treatment of early stage large cell lymphoma
Authors: Levitt Seymour H. , Lee Chung K. K. , Bloomfield Clara D. , Frizzera Glauco
Published: February 2007

Nineteen patients with localized non‐Hodgkin's lymphoma large cell type classified by the international formulation in group D (5) and group G (14) were treated with extended field radiation therapy. These patients have been followed for 168 months with range from 12 to 168 months from initiation of treatment. In G category of the formulation, the overall survival is 83 per cent at 5 and 10 years and recurrence‐free survival is 75 per cent at 10 years. Sixteen of the patients were stage I and three were stage II. Two patients died without evidence of recurrence. Four patients recurred and two of these died of disease. Thirteen of the 19 patients are alive and recurrence free. Bulk of disease had no apparent influence on the response to irradiation. We believe that the early pathological stage large cell lymphoma of the G and D type international formulation are appropriate candidates for radical radiation therapy and benefit from this approach to treatment.
Bone marrow examination in small cell carcinoma of the bronchus: An unnecessary procedure?
Authors: Mead G. M. , Williams C. J. , Thompson J. , Smith A. G. , Whitehouse J. M. A.
Published: February 2007

One hundred and thirty‐seven patients with small cell carcinoma of the bronchus underwent bone marrow trephine and/or aspirate examination as part of their clinical staging. Twenty‐four patients (17.5 per cent) were found to have malignant marrow infiltration. In no case was this an isolated finding of metastatic disease, indeed most patients had gross metastatic spread to liver and/or bone. Marrow infiltration has not been shown to be a major prognostic factor in response to chemotherapy or survival in previous studies. We recommend that this staging procedure be discontinued in routine clinical practice, and instead be confined to specific indications in clinical trials.
Adenosine deaminase in plasma of patients with adult T‐cell leukemia (ATL): Correlation between enzyme activity and the ATL subtypes
Authors: Oda Tetsuya , Kagimoto Tadashi , Aso Norio , Yamaguchi Kazunari , Tomino Shinhachiro , Takatsuki Kiyoshi
Published: February 2007

Adenosine deaminase (ADA) was assayed in plasma from 14 patients with adult T‐cell leukemia (ATL) (eight with acute ATL and six with smoldering or chronic ATL), 20 male family members (ten were anti‐ATLA antibody positive and the other ten negative), and 25 normal individuals. ADA activity was uniformly higher in plasma from patients with ATL than normal controls. This enzyme activity significantly increased in acute ATL in comparison to smoldering or chronic ATL. In families of ATL patients, no statistical difference in ADA activity between the anti‐ATLA antibody‐positive group and ‐negative group could be discerned. The enzyme activity in a patient with acute ATL, after a bone‐marrow transplant, rapidly increased as leukemic cells increased in peripheral blood. These findings indicate that the levels of ADA activities in plasma from ATL patients reflect the condition of this disease. Thus, measurement of this enzyme activity offers a further parameter to distinguish subtypes of ATL, and is of prognostic and therapeutic value.
Characterization of myeloid leukemias with monoclonal antibodies 3C5 and MY9
Authors: Matutes Estela , Rodriguez Bendjhui , Polli Nicoletta , de Castro J. Tavares , Parreira A. , Andrews Carolyn , Griffin J. D. , Tindle R. W. , Catovsky D.
Published: February 2007

The expression of two membrane antigens identified by the monoclonal antibodies (McAb) My9 and 3C5 has been investigated in cells from 80 acute leukemias. My9 was positive in the blasts of 33 out of the 38 (87 per cent) cases of acute myeloid leukemia (AML) tested, regardless of FAB subtype, and in 13 of 18 (72 per cent) cases of chronic granulocytic leukemia (CGL) in myeloid blast crisis. The reactivity of 3C5 was confined to myeloblastic (M1) AML, 85 per cent of cases, and to lymphoblastic leukemia (ALL) of B‐lineage, 70 per cent of cases, including CGL in lymphoid transformation. My9 was negative in ALL except for an unusual case. The phenotype My9+, 3C5+ was seen exclusively in M1 (69 per cent) and M2 (14 per cent) AML. Ultrastructural analysis with the immunogold method in combination with the myeloperoxidase (MPO) reaction showed that expression of My9 increased in parallel with MPO activity whereas 3C5 was expressed mainly in myeloblasts with little MPO content. We conclude that the use of these two McAb will contribute to the diagnosis and classification of AML and may throw some light to the pathogenesis of biphenotypic acute leukemias, including TdT + AML.
Adolescent and adult lymphoblastic leukaemia: Prognostic factors and response to treatment
Authors: Fraser G. G. , Hart D. N. J. , Heaton D. C. , Hamer J. W. , Allen J. , Beard M. E. J.
Published: February 2007

Thirty consecutive patients with acute lymphoblastic leukaemia (ALL) who received treatment at Christchurch Hospital between 1972 and 1982 were reviewed. Complete remission (CR) was achieved in 80 per cent with a median survival of 65 weeks. Eleven of 30 patients had one or more of the following features—B cell ALL, a mediastinal mass, the Philadelphia chromosome (Ph1) and age 60 years or older at diagnosis. Although CR was obtained in 8 of these patients none survived three years. The remaining 19 patients were regarded as ‘good risk’ and treated by moderate intensity chemotherapy schedules. CR was obtained in 16 of these patients (84 per cent) and the estimated 5 year survival was 62 per cent with 6 patients remaining in remission from 5 to 9 years from diagnosis.

These results demonstrate the value of objective and reproducible clinical and laboratory findings in defining a subset of ALL patients which may not require high intensity chemotherapy schedules.
Human t‐cell leukemia virus: Causative roles in development of adult t‐cell leukemia and provirus integration into leukemic cell DNA
Authors: Yoshida M. , Seiki M.
Published: February 2007

Human T‐cell leukemia virus (HTLV) was isolated from a cutaneous T‐cell lymphoma patient by Gallo and his colleagues (Poiesz et al., 1980) and adult T‐cell leukemia virus (ATLV) was isolated from patients with adult T‐cell leukemia (ATL) in Japan (Yoshida et al., 1982). Originally, these two viral isolates were thought to be different since they were isolated from apparently different tumors. However, we have shown that HTLV in the Caribbean and ATLV in Japan are the same virus (Watanabe et al., 1983, 1984) and the patient from which HTLV was isolated was identified as an atypical case of ATL (Bunn et al., 1983).
Malignant lymphomas in Japan: Epidemiological analysis on adult t‐cell leukemia/lymphoma
Authors: Tajima Kazuo , Tominaga Suketami , Suchi Taizan
Published: February 2007

According to the Vital Statistics Japan Series in 1950–1981, the age‐adjusted death rate for malignant lymphomas (ICDs, 200–202) in Japan has increased in recent years. A geographical clustering of malignant lymphomas in the Kyushu districts was observed both in the period 1969–1971 and more recently in 1979–1981. The excessive rate of malignant lymphomas in Kyushu was due to the high incidence of adult T‐cell leukemia/lymphoma (ATLL). The distribution of healthy carriers of ATLV, a human retrovirus which is almost identical to HTLV, was closely related to that of patients with ATLL in Japan. Epidemiological features of the infectious mode of ATLV suggested two main routes of natural transmission, one from mother to child and the other from husband to wife

ATLV is considered to be a main causative agent of ATLL from virological and epidemiological evidence, but infection by this virus alone may not result in ATLL because the incidence of ATLL among ATLV carriers was apparently not very high even in endemic areas of ATLL. Thus, some risk factors other than ATLV, such as environmental and genetic factors, may contribute to the development of ATLL.
lymphoma type adult T‐cell leukemia—a clinicopathologic study of HTLV related T‐cell type malignant lymphoma
Authors: Yamaguchi Kazunari , Yoshioka Ritsuko , Kiyokawa Tetsuyuki , Seiki Motoharu , Yoshida Mitsuaki , Takatsuki Kiyoshi
Published: February 2007

The clinical and pathological features of T‐cell type malignant lymphoma related to human T‐cell leukemia virus (HTLV) were investigated in eight patients presenting lymphadenopathy. Biopsy of lymph nodes showed an histology of diffuse non‐Hodgkin's lymphoma. All patients were positive for anti‐ATLA antibody and HTLV proviral DNA in the lymph node cells. Most patients showed pronounced hypercalcemia and high serum levels of lactic dehydrogenase. All patients died between 3 and 17 months (mean 8 months) after the onset of disease

HTLV‐related malignant lymphoma should be added to the spectrum of ATL, being classified as a lymphoma type ATL.
The effect of vinblastine on CFU‐E IN normal and W anaemic mice
Authors: Chervinsky David S. , Tebbi Cameron , Williams Douglas , Orsini Frank , Fitzpatrick John , Freeman Arnold I.
Published: February 2007

Using a plasma clot technique, we studied the comparative levels of in vitro erythroid colony forming units (CFU‐E) of normal and W anaemic mice following intravenous (IV) injection of 6·25 mg/kg of vinblastine (VBL). Mice used in this study were C57B1/6J, WBB6F,1, (+/+, WVv/+ and W/Wv). CFU‐E content was looked at on day 0, 1, 3, 5, 7 and 10 following IV VBL. The CFU‐E content of bone marrow (BM) and spleen was adequate prior to VBL treatment in all four mouse strains tested. We found IV VBL resulted in a significant rebound of CFU‐E production in spleens of all four mouse strains. Most CFU‐E production occurred on days 7 and 10 post VBL. The total CFU‐E content of BM was not significantly affected by VBL in C57B1/6J, WBB6F1, +/+ and Wv/+ mice. However, a significant reduction of total CFU‐E was seen in the BM of WBB6F1, W/Wv mice. This plus the fact that increased CFU‐E is seen in the spleen of all mouse strains including W/Wv suggests that there may be differing cellular or environmental factor(s) in different hematological organs controlling CFU‐E of the W/Wv mouse.
Diagnosis and treatment of fungal infections in patients with hematologic malignancies
Authors: Radaelli F. , Cortelezzi A. , Zocchi L. , Castagnone D. , Baldini L. , Colombi M. , Mozzana R.
Published: February 2007

A diagnosis of deep‐seated mycosis was made in 54 patients with hematologic malignancies, severe neutropenia and fever, based on a set of clinical and laboratory criteria. Standardized antifungal treatment was started in 31 patients who seven days after onset of fever had not responded to antibiotics; the fungal infection was cured in 13, all of whom had a simultaneous remission of neutropenia, whereas the other 18 who did not respond to antifungal treatment, all had a falling or static neutrophil count. None of the 23 patients who were given no or inadequate antifungal treatment survived regardless of the neutrophil count and/or phase of the hematologic disease. We discuss the suitability of utilizing empirical criteria for a diagnosis of disseminated fungal infection as a basis for starting antifungal therapy in this type of patient.
Second primary malignant neoplasms in patients treated for hodgkin's disease at st bartholomew's hospital
Authors: Dorreen M. S. , Gregory W. M. , Wrigley P. F. M. , Stansfeld A. G. , Lister T. A.
Published: February 2007

The incidence of second malignant neoplasms (SMN's) was investigated in a group of 529 patients with Hodgkin's Disease (HD) treated at St Bartholomew's Hospital (SBH). SMN's were seen in 27 of these patients giving an incidence rate three and a half times that expected in an age and sex matched normal population (p = ≦ 0·001). The incidence rate was higher in those receiving multiple chemotherapy and radiotherapy for relapsed HD compared with those receiving primary radiotherapy, chemotherapy or chemotherapy with adjuvant radiotherapy (p = 0·02). However, the increased incidence rate in those patients treated with chemotherapy on relapse, may reflect in part a delayed effect of their primary therapy, since the incidence rate in the primary treatment group only becomes significantly raised after six years. When allowance was made for this delay the difference between the two groups was no longer significant

The incidence rates for Non‐Hodgkin's Lymphoma (NHL) and myelogenous leukaemia were 32 and 57 times those expected, compared with only two and a half times the expected rate for non‐haematological SMN's (p = » 0·001). The four acute myeloid leukaemias (AML) all occurred within five years of treatment compared to wide‐ranging intervals between treatment and occurrence of SMN in the other groups. The increased incidence of NHL may be an alternative expression of lymphoid abnormality rather than a treatment‐related occurrence. Multiple SMN's were diagnosed in three patients. This represented a highly significant (p = « 0·001) increase over the expected incidence of multiple neoplasia in the general population

Several factors may contribute to the development of SMN's in HD, including an inherent disposition of HD itself. The time‐dependent incidence pattern of SMN's with a delay followed by an increased incidence rate, suggests that treatment plays a key role. It is not yet clear whether more intensive, or multiple treatments add to the risk accrued for the initial treatment.
Mediastinal germ cell tumour associated with malignant histiocytosis and high rubella titres
Authors: Ashby M. A. , Williams C. J. , Buchanan R. B. , Bleehen N. M. , Arno J.
Published: February 2007

Two further cases of a haematological malignancy are reported in patients with mediastinal germ cell tumours. Two young men developed bone marrow infiltration with histiocytes showing erythrophagocytosis shortly after subtotal excision of a malignant teratoma of the anterior mediastinum. Serial viral titres showed a rise in rubella antibody titres by haemoagglutination inhibition in both cases, antirubella IgG (ELISA) in one case and rubella RH zone in the other, in the absence of detectable IgM rubella antibiodies. In case 1 a diagnosis of virus associated haemophagocytic syndrome was made and he was treated with interferon and steroids. In case 2 the diagnosis was initially idiopathic thrombocytopenia purpura but he deteriorated on steroids, and was subsequently unsuccessfully treated with chemotherapy and gamma globulin infusions. The disease ran a rapid downhill course with progressive marrow failure and they both died 5 months after diagnosis. Review of the presenting histology, the progressive course of the disease and post mortem histology, suggests that they had malignant histiocytosis. The association between mediastinal teratoma and haematological malignancy is of biological importance. Serial viral titres should be measured in patients with malignant histiocytosis to see if there is a raised rubella titre. Such viral studies are also warranted where there is an association between a mediastinal germ cell tumour and haematological malignancy.