Treatment of locally advanced carcinoma of the urinary bladder with preoperative radiotherapy and radical cystectomy versus radical cystectomy alone

Metastasis to the orbit from pancreatic adenocarcinoma is rare. A 38-year-old man with metastatic adenocarcinoma of the right orbit at initial examination is described. Two months later he was diagnosed with a pancreatic primary tumor. The incidence and pattern of orbital metastasis in carcinomas is briefly discussed.     

Biological properties of recombinant alpha-interferons: 40th anniversary of the discovery of interferons

IFNs were first described as potent antiviral agents 40 years ago, and recombinant IFN-alpha2a and IFN-alpha2b were approved for the treatment of hairy cell leukemia just 11 years ago. Today, alpha-IFNs are approved worldwide for the treatment of a variety of malignancies and virologic diseases. Although the exact mechanism of action of IFN-alpha in the treatment of such diseases is not fully understood, many advances have been made in the characterization of the physicochemical and diverse biological properties of this highly pleiotropic cytokine. Here we review recent developments in our understanding of the antiviral and immunoregulatory properties of IFN-alpha, the nature of the multisubunit IFN-alpha receptor, and the molecular mechanisms of signal transduction. Where available, we have included comparative data on recombinant alpha-IFNs derived from both naturally occurring and nonnaturally occurring synthetic genes. We also review clinical data and data on the side effects and antigenicity of different sources of recombinant alpha-IFNs in humans. These latter topics are of clinical interest, because they may potentially affect the efficacy of these various products. Hopefully, what is already known about IFN will prompt further exploration into the mechanism(s) of action of IFN-alpha and thus deliver new applications for this prototypic cytokine, whose full therapeutic potential is yet to be realized.     

Intraclass correlation estimates in a school-based smoking prevention study. Outcome and mediating variables, by sex and ethnicity

Most school-based smoking prevention studies employ designs in which schools or classrooms are assigned to different treatment conditions while observations are made on individual students. This design requires that the treatment effect be assessed against the between-school variance. However, the between-school variance is usually larger than the variance that would be obtained if students were individually randomized to different conditions. Consequently, the power of the test for a treatment effect is reduced, and it becomes difficult to detect important treatment effects. To assess the potential loss of power or to calculate appropriate sample sizes, investigators need good estimates of the intraclass correlations for the variables of interest. The authors calculated intraclass correlations for some common outcome variables in a school-based smoking prevention study, using a three-level model-i.e., students nested within classrooms and classrooms nested within schools. The authors present the intraclass correlation estimates for the entire data set, as well as separately by sex and ethnicity. They also illustrate the use of these estimates in the planning of future studies.