Intralesional bleomycin

BACKGROUND: The pH-values of artificial tears have not been examined up to now. MATERIALS AND METHODS: The pH-values of 20 commercially available artificial tears were determined. RESULTS: pH-values measured from 4.82 to 8.39. One sixth showed pH-values above physiological values. CONCLUSION: A remarkable proportion of commercially available artificial tears deviate from the physiological range of the pH. It does not seem advisable to apply those in eyes with damaged anterior segments.     

Responsiveness of experimental surgical-wound infections to topical chemotherapy

The anterior dentition of three species of African colobines (Colobus polykomos, C. badius, and C. verus) was investigated metrically and the results analyzed for three characters: (1)intraspecific tooth size relations, (2)sexual dimorphism, and (3)interspecific relations. Based on incisor size sequences C. polykomos and C. badius appear to be more closely related to each other than either is to C. verus. However, incorporating the results of a previous study on postcanine dentition the three species appear to be equally closely related. The magnitude of sexual dimorphism in canine size decreases from C. badius to C. verus to C. polykomos. Interspecific differences in the degree of canine size dimorphism may be attributed to differential intensities of male intrasexual selection; however, the interspecific differences in canine size dimorphism do not correspond to the interspecific differences in body size dimorphism.     

Intralesional photocoagulation of periorbital hemangiomas

The purpose of this study was to examine the effects of intralesional bare fiber photocoagulation with the KTP and Nd:YAG lasers on periorbital hemangiomas of infancy. Initial reports by Apfelberg and Gregory suggest that intralesional laser therapy may have a role in the treatment of hemangiomas. Intralesional photocoagulation may be preferred to superficial laser treatment for several reasons. It may decrease cutaneous skin damage and more effectively reduce bulky, deep lesions. Twenty-three patients with periorbital hemangiomas were treated (KTP, n = 7; Nd:YAG, n = 16). An 18-g Angiocath was placed into the lesion to pass the fiber through. Laser energy was delivered by means of a 0.6-mm bare fiber at 10 to 15 J (KTP) or 7 J (Nd:YAG). Treatments were done under general anesthesia. Patients were followed closely for 1 month and then monthly to assess results and complications. Results are as follows: 61 percent demonstrated 50-percent or more reduction at 3 months; 22 percent demonstrated 50-percent or more reduction in 3 to 8 months, i.e., 83 percent of patients had 50-percent or more reduction within 8 months. To achieve these results, two patients required two treatments. The remaining 17 percent had 10- to 14-percent reduction at 1 to 3 months. Two of these patients had two treatments. A subgroup of patients had a very dramatic response. Thirty-five percent (8 of 23) had 50- to 90-percent reduction in 1 month. It is unclear why these patients responded so dramatically. We expected some ulceration during the healing phase. Seventeen percent developed ulceration. Complications were limited (4 percent) to one wound infection. Intralesional photocoagulation treatment with the KTP and Nd:YAG lasers is effective and safe for the treatment of periorbital hemangiomas in the majority of patients with minimal complications. Further study is necessary to identify factors that result in dramatic or limited responses.     

A proper sequence for the treatment of B16 melanoma: chemotherapy, surgery, and immunotherapy

The therapeutic effectiveness of surgery, chemotherapy, and immunotherapy alone and in combination were studied in the B16 melanoma model. The sequence of chemotherapy and immunotherapy as adjuvants to surgery proved important: Chemotherapy was significantly better when given before surgery; immunotherapy was more effective when delivered after surgery. The most effective therapeutic regimen was a combination of all three modalities: a single course of chemotherapy preceding surgery followed by immunotherapy.     

Treatment of neuroblastoma stage 4 with 131I-meta-iodo-benzylguanidine, high-dose chemotherapy and immunotherapy. A pilot study

Disseminated neuroblastoma after infancy has a prognosis of approximately 10-20% with conventional therapy. We investigated the role of high-dose chemotherapy (HDCT) with peripheral blood stem cell (PBSC) rescue in combination with 131I-metaiodobenzylguanidine ([131I-m]IBG). 11 children with neuroblastoma stage 4 were pretreated within the German Neuroblastoma Trial NB90 and included in a high-dose concept for consolidation. Remission was documented by ultrasound, CT, NMR, or [123I-m]IBG scanning. HDCT was a combination of melphalan (180 mg/m2), carboplatin (1,500 mg/m2) and etoposide (40 mg/kg). All children were treated by [131I-m]IBG (0.58 GBq/kg) prior to high-dose treatment. All 11 children were additionally treated with antiGD2 murine- or chimeric-antibody (ch14.18). 4 children had no change to their remission status but three achieved a complete response (from a partial response to first line) and one a partial response (from no response to first line). The other 3 children progressed, 2 dying of their disease. Using Kaplan-Meier analysis, the probability of progression-free survival was 0.70 +/- 0.15 with a median observation time of 19 months. 9/11 children are alive, 8 without progression or relapse, whilst 2 have died of their disease. The combination of mIBG plus high-dose chemotherapy with PBSC support supplemented by immunotherapy with antiGD2 antibody appears to be a feasible and effective treatment regimen for disseminated neuroblastoma in this limited series. Larger numbers of patients should be treated to confirm these results.     

Allergen immunotherapy and avoidance

Since its introduction almost a century ago, immunotherapy continues to be an effective method of managing allergic rhinitis, allergic asthma, and insect anaphylaxis. Confusion and misinformation on the part of physicians and the public lead to the inappropriate use of this treatment. Before immunotherapy is started, appropriate avoidance techniques and pharmacotherapy should be instituted (except for insect anaphylaxis, where immunotherapy is a part of the initial treatment.) When these measures fail, or significant side effects are encountered, immunotherapy can be beneficial. This article eliminates as much as possible the ambiguity surrounding immunotherapy to help the clinician understand more clearly the appropriate use of immunotherapy and the treatment of allergic diseases.     

Intralesional radiolabeled human monoclonal IgM in human tumor xenografts

Sensory-perceptual abnormalities in people with autism are discussed from two perspectives: published firsthand accounts and existing psychological research evidence. A range of abnormalities, including hyper- and hyposensitivity, sensory distortion and overload, and multichannel receptivity and processing difficulties, are described in firsthand accounts and frequently portrayed as central to the autistic experience. A number of dangers are inherent in uncritically accepting these accounts at face value and in any wider generalization to the autistic population as a whole. Evidence from clinical studies suggests that unusual sensory responses are present in a majority of autistic children, that they are manifested very early in development, and that they may be linked with other aspects of autistic behavior. In addition, experimental studies using a range of indices have found evidence of unusual responses to sensory stimuli in autistic subjects. However the clinical and experimental research to date suffers from serious methodological limitations and more systematic investigation is warranted. Key issues for future psychological research in the area are identified.     

Immunopathogenesis and immunotherapy of psoriasis

The c-MET oncogene encodes the receptor for the Hepatocyte Growth Factor/Scatter Factor (HGF), a cytokine that stimulates the invasive growth of normal and neoplastic cells. The Met/HGF receptor is expressed by epithelial cells and its ligand by cells of mesenchymal origin. Receptor-ligand interaction occurs via a paracrine circuit. We studied the expression of the Met/HGF receptor and of its ligand in mesenchymal human tumours by examining 39 clinical samples of bone tumours. The Met/HGF receptor was not detectable in the majority of bone tumours, as expected from their mesenchymal origin. Notably, the receptor was overexpressed in 60% of the osteosarcomas examined. In 12 osteosarcoma cell lines the Met/HGF receptor was overexpressed, phosphorylated by HGF stimulation and fully functional. HGF was detected in two out of seven clinical specimens of osteosarcoma. The ligand and the receptor are co-expressed in two clonal osteosarcoma cell lines. In these lines the Met/HGF receptor was constitutively phosphorylated; phosphorylation was suppressed by suramin treatment, a known blocker of autocrine loops. These data suggest that activation of the Met/HGF receptor by a paracrine or an autocrine mechanism might play a role in the particularly aggressive behaviour of osteosarcomas.     

Intralesional bleomycin-mediated electrochemotherapy in 20 patients with basal cell carcinoma

BACKGROUND: A new anticancer therapy, electrochemotherapy (ECT), has been introduced that entails exposing cancerous tissues to short pulses of electricity during chemotherapy. This enhances cell membrane permeability and has been shown to have potent antitumor effects in vitro in animal models and in several clinical trials, including nevoid basal cell carcinoma (BCC). OBJECTIVE: We report the effects of ECT on 20 patients with primary BCC. METHODS: Electrical pulses were delivered to 54 tumors after administration of intralesional bleomycin sulfate. RESULTS: Complete responses were observed in 53 (98%), and in the majority of these (94%) after a single treatment. No recurrences have been recorded with a mean of 18 months of observation. CONCLUSION: Although these are preliminary results, ECT appears to be an effective alternative to surgical excision for the treatment of primary BCC.     

Nasal allergen challenge and immunotherapy control

Nasal allergen challenges, despite not reproducing exactly natural allergen exposure, are a very useful method to understand the complex cellular kinetics and cellular interactions that occur in allergic rhinitis. Cell-specific soluble mediator measurements can give useful diagnosis information as well as complementary information regarding the monitoring of specific immunotherapy. In this article we present data concerning eosinophil cationic protein and tryptase measurements after nasal allergen and the influence of specific immunotherapy on nasal peak flow before and 1, 2 and 3 years after starting immunotherapy.     

Interleukin-2 immunotherapy and cutaneous manifestations

The cutaneous manifestations which follow the administration of recombinant interleukin-2 (rIL-2) are well known, but their nature and severity have not yet been fully studied. The authors report the dermatological changes observed in 12 patients treated with rIL-2 for renal cancer. The predominant lesion was generalized erythema followed by desquamation.     

Specific immunotherapy using allergens apropos of specific immunotherapy by the sublingual route

The present number of publications an allergen specific immunotherapy (ITa) by clinically controlled tests, double blind, is objective proof of the value of this treatment in the allergy pathologies mediated by IgE. The mechanisms of action of Ita are better understood, taking account of the intervention of TH2 and TH1 cells with the respective involvement of cytokines IL4-IL5, favouring the synthesis of IgE and interferon gamma (IFN gamma) slowing the synthesis of IgE. Adjuvants of bacterial origin influence the balance TH2/TH1 by blocking the production of TH2 cells. Ita by the sublingual route (SLIT) has been the objective of double blind clinical studies, with favourable results and good tolerance, of a number of allergens, pollens (grass, ragweed, parietaria, olive) and D. pteronyssinus mites. Application of this technique of SLIT to foods and drugs reveals more a mechanism of customisation than induction of cellular acticity, of a mucosal secretory IgA and an oral tolerance with systemic response, mechanisms that are involved in SLIT. Taking into account the restrictions of ITa, SLIT allows inclusion of other allergic patients, such as children receiving injections and subjects who are not inclined to observe and comply with treatment.... The different techniques used for classical ITa by the subcutaneous route are also useable for SLIT with a very good tolerance, apart from some transitory digestive problems. SLIT is no longer a technique of the future, but already one of the present time, currently used and which gives a renewal of value in the form of therapy that is ITa for IgE-mediated allergy pathology.     

Intralesional excision compared with en bloc resection for giant-cell tumors of bone

We reviewed the results for forty consecutively seen patients, each of whom had been managed by one surgeon for a giant-cell tumor of bone in an extremity between 1976 and 1990. Twenty patients had been managed with an en bloc resection and twenty, with an intralesional excision of the tumor with adjunctive local insertion of methylmethacrylate or phenol. All patients had been followed for a minimum of two years. Both en bloc resection and intralesional excision were found to be excellent oncological procedures. There were fewer complications and better functional results after the intralesional procedure than following the en bloc resection.