Definitive irradiation of nasopharyngeal carcinoma: analysis of results and failures in 103 cases.

During the period 1975-1984, 103 patients were treated for nasopharyngeal carcinoma. Most of them presented with an advanced stage: 64 stage IV and 26 stage III. Sixty-one patients presented with neck nodes, which was the most frequent symptom of presentation. The histologic subtypes included 64 squamous cell carcinoma and 39 undifferentiated carcinoma. All patients were treated by high energy sources with portals encompassing the primary and the whole neck. Doses ranged from 50-55 Gy in T1 patients to 65-70 Gy in T4 patients. The mean survival was 58.5 months, and 31 patients were alive and disease free at 60 months from treatment. A clear difference in survival emerged among T1, T2-3, and T4 patients (p greater than 0.01), whereas there was no significant difference between T2 and T3 patients. Also, N0 and N1 showed no significant difference in 5-year disease-free survival (38% and 41%, respectively); only 20% of N2 and 7% of N3 patients survived for more than 5 years. As regards histology, 25% of patients with a squamous cell carcinoma and 36% of those with an undifferentiated carcinoma were alive at 5 years. The presence of distant metastases (in 20 patients) was not correlated with T stage but was strongly correlated with N stage; histology did not affect the development of metastases. There clearly was no correlation between T and N stage, a behavior which probably constitutes a characteristic of these tumors. From our analysis we can affirm that N stage has a greater influence on prognosis and final outcome than T stage, at least using the UICC staging criteria.

Postoperative management of primary spinal cord ependymomas.

Treatment and final outcome of 11 patients with primary spinal cord ependymomas admitted between 1967 and 1983 have been reviewed. All patients had undergone surgery once or twice before radiation treatment. Six of them are alive and disease-free 78 months to more than 180 months after radiation therapy. A short analysis of the recent literature is presented with special emphasis on the most frequent treatment techniques, extension of radiation fields and doses. The value of postoperative radiation therapy and the complications of both surgery and radiotherapy are analyzed. Some guidelines for treatment are finally discussed and proposed.

Comparative evaluation of RAST and MAST-CLA for six allergens for the diagnosis of inhalant allergic disease in 232 patients.

The aim of this study was to compare a recent multiple allergosorbent chemiluminescent assay (MAST-CLA) with the RAST for the diagnosis of inhalant allergic disease in 232 patients with rhinitis and/or bronchial asthma. As judged by concordance of clinical history, skin prick tests to a range of six allergens common to our geographic area, and by nasal provocation tests, 70 patients were non-allergic and 162 allergic: 70 to grasses, 46 to mites, four to mugwort, eight to pellitory, and 34 were sensitive to several allergens. In our patient sample that, among other things, comprises subjects with fairly rare monoallergies, MAST-CLA testing gave results which closely corresponded to positive RAST for the allergens studied, and demonstrated a close correlation with the diagnosis of inhalant-specific allergy. Our results showed that, for overall allergens, MAST-CLA was lightly less sensitive and more specific than RAST (the two in vitro tests gave an identical overall efficiency).

Postoperative irradiation of brain ependymomas. Analysis of 33 cases.

Treatment and final outcome of 33 patients with brain ependymoma were reviewed. All patients had been operated, but the surgical removal was incomplete in the great majority of cases. Radiation therapy was subsequently performed using one of the following techniques; a) partial brain irradiation against the primary involved areas in 17 cases, b) whole brain irradiation plus boost against primary involved sites in 6 cases and c) total craniospinal irradiation in 7 cases. Three patients were not eligible for the present study because of underdosage. Five- and 10-year survival rates were 48 and 38% respectively. A short survey of recent literature is presented. The possible causes of failure and the methods for postoperative irradiation are discussed against the background of literature and our own cases.

In vitro stability of the reticulocyte count.

A collaborative study was undertaken to investigate the effect of storage conditions on the measured reticulocyte count in venous blood samples. It was designed to cover variation in the three main determinants, namely time, temperature and anticoagulant. The aim was to determine the time for which samples could be stored for subsequent analysis for clinical purposes.

Contracepcion intrauterina con multiload Cu 250. / Intrauterine contraception with multiload Cu-250

Se hizo un analisis de 437 usuarias del dispositivo intra-uterino tipo Multiload Cu-250 insertados a dos grupos de pacientes (273 de consulta de planificacion familiar y 164 de consulta privada). La edad de las usuarias oscilo entre 15 y 45 anos (89,70% tenian entre 20 y 34 anos). El numero de gestaciones previas era entre 0 y 18 por usuaria con una paridad entre 0 y 12 partos (86,60% tenian entre 0 y 4 partos) y con antecedente de cesarea en 21 de los casos. El tiempo de uso vario entre 6 y 36 meses exceptuando aquellas usuarias que presentaron algun evento (expulsion, retiro, embarazo). Los resultados encontrados fueron: 1) Los embarazos alcanzaron a los 6 meses el 0,45%, a los 12 meses 1,59%, a los 18 meses 2,28%, a los 24 meses el 2,97%, manteniendose asi hasta los 36 meses de uso. 2) el porcentaje de expulsiones a los 6 meses fue de 0,92%, a los 12 meses 1,38, a los 18 meses 1,61%, mateniendose asi hasta los 36 meses de uso 3) No se registro ninguna perforacion. 4) Los retiros por causa medica (sangramiento y/o dolor) alcanzaron el 1,14% a los 6 meses, 4,8% a los 12 meses, 6,4% a los 18 meses, 6,63% a los 24 meses y 6,86% a los 36 meses do uso. 5) No existieron complicaciones graves, ni muertes relacionadas con este tipo de dispositivo