Quantitative fluorescence microscopy of macromolecules in gel and biological tissue.

Quantitative fluorescence microscopy provides valuable insight into drug delivery and pharmacokinetics. The technique is based on analysis of statistical fluctuations in fluorescence that arises as fluorophores pass through a small volume illuminated by a focused laser beam, and has been applied to measure particle motion and binding interactions in solutions, on surfaces and inside the cells. We examined the use of fluorescence correlation spectroscopy combined with a microscope (FCSM) to assess the transport of fluorescent beads and macromolecules in aqueous solutions, gels and living biological tissue. Obstructed diffusion of fluorescent beads in gels of various densities was tested to get a sensible estimate of diffusion in the interstitial tissue matrix consistent with previous reports. Fluorescently labelled liposomes as an artificial drug or gene carrying vehicles were used for pharmacokinetic tests of drug delivery in living tissue. The results indicate that FCS is an accurate and valuable tool for measuring the physical properties of gene vectors in vitro and for characterizing interactions with tissue in vivo.

Outcome following surgical treatment for regional metastases from cutaneous cancers of the head and neck in patients aged 80 and over.

INTRODUCTION: Population demographics and disease epidemiology is resulting in more elderly patients presenting with regional metastases from cutaneous malignancy of the head and neck region. Surgery remains the most appropriate primary treatment option. PATIENTS AND METHODS: We analysed consecutive patients aged 80 and over who developed regional metastases from cutaneous cancers of head and neck and underwent a neck dissection over a two-and-a-half-year period. Data were obtained from the cancer database and patients' notes. A Kaplan-Meier survival graph was constructed. RESULTS: Our study demonstrated a low postoperative morbidity but one patient died from medical complications with in the first 30 days post surgery. The median survival time following surgery is nearly two years. CONCLUSIONS: We continue to advocate primary surgery for cutaneous metastatic malignancy from the head and neck area but patients need multidisciplinary team discussions, thorough assessment and counselling.

Serum C-reactive protein as a prognostic indicator in patients with oral squamous cell carcinoma.

Preoperative elevation of serum C-reactive protein (CRP) has been demonstrated as a prognostic indicator in oesophageal, gastric and colorectal cancer. This study was designed to establish if elevated preoperative levels of serum CRP could predict the prognosis of patients treated with primary surgery for oral squamous cell carcinoma (SCC). Sixty patients with oral SCC who were treated by primary surgery and microvascular free flap reconstruction, were included in the study. The relation between preoperative levels of serum CRP, clinicopathological features and patient prognosis was determined. This study showed using bivariate analysis (p=0.003) and multivariate analysis (p<0.001) that a raised preoperative CRP was associated with worse overall survival. Tumour size and stage when combined with CRP levels increases the predictive power of this indicator.