Interferon adjuvant to radical nephrectomy in Robson stages II and III renal cell carcinoma: a multicentric randomized study.

PURPOSE: Because interferon gave promising results in the management of metastatic renal cell carcinoma in the 1980s, a multicentric randomized controlled trial was planned to compare adjuvant recombinant interferon alfa-2b (rIFNalpha2b) with observation after radical nephrectomy in patients with Robson stages II and III renal cell carcinoma. Overall and event-free survival were to be evaluated together with prognostic factors. PATIENTS AND METHODS: Overall and event-free survival curves for 247 patients (124 controls and 123 treated) were estimated by the Kaplan-Meier method and compared using the log-rank test. Cox's multiple regression models were adopted to perform a joint analysis of treatment and prognostic factors. RESULTS: The 5-year overall and event-free survival probabilities were 0.665 and 0.671, respectively, for controls and 0.660 and 0.567, respectively, for the treated group; the differences were not statistically significant (2P = .861 for overall and 2P = .107 for event-free survival with the log-rank test). Regarding prognostic factors, only grade, pT, and pN demonstrated a significant prognostic role. First-order interactions of treatment with pT and pN category were investigated; a significant interaction was found between pN and treatment. A harmful effect of rIFNalpha2b in the 97 treated pN0 patients and a protective effect in the 13 treated pN2/pN3 patients were statistically significant. CONCLUSION: Adjuvant rIFNalpha2b is not indicated after radical nephrectomy for renal cell carcinoma. The protective effect in the small group of pN2/pN3 patients requires further investigation.

Fully symmetric nulling beam combiners.

A simple method of nulling broadband light is presented. A mirror-symmetric pair of right-angle periscopes is first used to introduce a geometric field flip between two incident light beams, after which the light is combined by means of one of a number of constructive two-beam interferometers. A reciprocal pair of beam-splitter passages provides for complete symmetry. Such an approach greatly eases beam-splitter design requirements and should find use both in initial ground-based nulling experiments and ultimately in space-borne interferometers targeted at direct extrasolar planet detection.

Endometrioid carcinoma of the ovary: a retrospective analysis of 106 cases.

AIMS AND BACKGROUND: This report retrospectively analyzes 106 cases of endometrioid carcinoma of the ovary treated at the National Cancer Institute of Milan from 1974 through December 1993. In 12 of the 106 cases (11.3%) a synchronous carcinoma of the uterine body was observed. METHODS AND STUDY DESIGN: Only patients who had previously untreated disease were included in the study. Patients with synchronous tumors were staged according to their ovarian cancer and treated according to the stage of that disease. RESULTS: Thirty-nine patients (36.8%) had stage 1, 17 (16.0%) stage 11, 43 (40.6%) stage III, and 7 (6.6%) stage IV disease. Moderately plus poorly differentiated tumors were present in 76 of the 106 cases (71.7%). Considering the 67 patients with advanced disease, residual tumor was absent in 27 cases (40.3%), < or = 2 cm in 17 (25.4%), and > 2 cm in 23 (34.3%) cases. Systematic pelvic and para-aortic lymphadenectomy was performed in 60 patients (56.6%); selective sampling was carried out in 23 cases (21.7%). After surgery, 77 patients underwent various chemotherapy regimens. CONCLUSION: Using univariate analysis, FIGO stage, tumor grade, residual disease after surgery, lymph node status, and platinum in the chemotherapy regimen significantly influenced 5-year survival. However, when all these variables were included in a multivariate analysis only FIGO stage still had a significant impact on survival. Survival analysis also showed a trend towards longer survival in patients with synchronous tumors.

Erythema nodosum: a presenting sign of early onset sarcoidosis.

"Early onset sarcoidosis" is a chronic granulomatous disease occurring in children younger than 5 years of age, and characterized by a classic symptom triad consisting of skin, eye and joint lesions, with on rare occasion pulmonary involvement. The disorder often goes unrecognized because of its rarity and, since polyarthritis and uveitis are the predominant symptoms, most of these children are misdiagnosed as having juvenile chronic arthritis (JCA). A child with erythema nodosum at 7 months of age, later diagnosed as JCA and definitively recognized as "early onset sarcoidosis" is reported. This case shows that, whenever possible, a biopsy showing the typical picture of sarcoid granulomas is crucial to distinguish these clinical conditions.

Interferometric seeing measurements on Mt. Wilson: power spectra and outer scales.

We have measured power spectra of atmospheric phase fluctuations with the Mark III stellar interferometer on Mt. Wilson under a wide variety of seeing conditions. On almost all nights, the high-frequency portions of the temporal power spectra closely follow the form predicted by the standard Kolmogorov-Tatarski model. At lower frequencies, a variety of behavior is observed. On a few nights, the spectra clearly exhibit the low-frequency flattening characteristic of turbulence with an outer-scale length of the order of 30 m. On other nights, examination of individual spectra yields no strong evidence of an outer scale less than a few kilometers in size, but comparison of the spectra on different interferometer baselines shows a saturation of the spatial structure function on long baselines. This saturation is consistent with the assumption of an outer-scale length similar to that derived for the nights when low-frequency flattening of the spectra is clearly seen. We discuss possible explanations of this behavior and conclude that power spectra from a single interferometer baseline are a poor diagnostic for the effective outer scale compared with multiple-baseline spectra.

Orbiting stellar interferometer for astrometry and imaging.

The orbiting stellar interferometer (OSI) is a concept for a first-generation space interferometer with astrometric and imaging goals and is responsive to the recommendations of the Astronomy and Astrophysics Survey Committee for an astrometric interferometer mission. The OSI, as developed at the Jet Propulsion Laboratory over the past several years, is a triple Michelson interferometer with articulating siderostats and optical delay lines. Two point designs for the instrument are described.

The 18-m design uses an 18-m maximum baseline and aperture diameters of 40 cm; the targeted astrometric performance is a wide-field accuracy of 10 microarsec for 16-mag objects in 100 s of integration time and for 20-mag objects in 1 h. The instrument would also be capable of synthesis imaging with a resolution of 5 marcsec, which corresponds to the diffraction limit of the 18-m base line. The design uses a deployed structure, which would fold to fit into an Atlas HAS shroud, for insertion into a 900-km sun-synchronous orbit In addition to the 18-m point design a 7-m point design that uses a shorter base line in order to simplify deployment is also discussed. OSI's high performance is made possible by utilizing laser metrology and controlled-optics technology.

Female health care during Operation Desert Storm: the Eighth Evacuation Hospital experience.

Little has been published concerning female soldiers' health care during combat. Therefore, a retrospective review of the Eighth Evacuation Hospital's gynecological records was performed while involved in Operation Desert Shield/Storm. Additionally, a health care survey was distributed to female soldiers. This review revealed that a large part of the hospital's gynecological resources during this conflict were employed treating preventable conditions. These problems could have been avoided if appropriate measures had been taken prior to deployment. It was concluded that all female soldiers should be required to undergo a gynecological health care screen prior to deployments.

Evaluation of NCS rapid plasma reagin card test, a new screening kit for syphilis.

Agreements in qualitative and quantitative test results between the recently marketed NCS rapid plasma reagin card test (NCS Diagnostics Corp.) and the Macro-Vue rapid plasma reagin 18-mm circle card test (Hynson, Westcott and Dunning) were 99.2 and 99.1%, respectively, indicating the NCS RPR card test to be an acceptable alternative procedure for the serodiagnosis of syphilis.

Atmospheric phase measurements with the Mark III stellar interferometer.

The Mark III interferometer is a phase-coherent stellar interferometer designed for astrometry. Operating through the turbulent atmosphere, the instrument is also a sensitive detector of atmospheric phase fluctuations. The effect of phase fluctuations on astrometric accuracy is reviewed, and phase measurements obtained with the instrument at Mt. Wilson using a 12-m base line are presented. These measurements agree well with the predictions of a simple Kolmogorov spatial spectrum over the frequency range of 0.001-100 Hz. From these measurements, the outer scale of turbulence for propagation through the entire atmosphere is estimated to be >2 km. The standard deviation for an absolute astrometric measurement estimated from these measurements is ~0.14T(-?) sec of arc for long integration times for conditions of 0.5-sec of arc seeing. For star-switched relative measurements, this error should decrease as the square root of the number of switching cycles.

Two-color method for optical astrometry: theory and preliminary measurements with the Mark III stellar interferometer.

The two-color method for interferometric astrometry provides a means of reducing the error in a stellar position measurement attributable to atmospheric turbulence. The primary limitation of the method is shown to be turbulent water vapor fluctuations, which limit the amount of improvement over a one-color measurement obtainable with a two-color estimate. Secondary atmospheric effects caused by diffraction from small refractive-index inhomogeneities and differential refraction for the observation of stars away from zenith are shown to introduce errors that behave as white noise and which should usually not be significant. Other potential error sources due to photon noise, systematic instrumental effects, and imperfect data reduction are also considered. The improvement in accuracy possible with the two-color method is estimated as a factor of 5-10 over the corresponding one-color measurement. Some preliminary two-color measurements with the Mark III stellar interferometer at Mt. Wilson are presented which demonstrate a factor of ~5 reduction in the amplitude of the atmospheric fluctuations in a stellar position measurement.

Reactivity of Dade rapid plasma reagin card test with low-titer sera.

Of 105 sera having reagin titers of 1 dilution as determined by the rapid plasma reagin 18-mm circle card test (Hynson, Westcott and Dunning, Baltimore, Md.), 103 (98.1%) were reactive with the Dade rapid plasma reagin card test (Biokit Laboratories, Barcelona, Spain), indicating that the two procedures are comparable in their ability to detect low levels of nontreponemal syphilitic antibody, or reagin.