Evaluation of micrometastases in sentinel lymph nodes of cutaneous melanoma: higher diagnostic accuracy with Melan-A and MART-1 compared with S-100 protein and HMB-45.

Accurate diagnosis of micrometastases in sentinel lymph nodes of cutaneous melanoma is critical for proper clinical management. S-100 protein and HMB-45 are the traditional immunomarkers widely used for this purpose. However, the interpretation of micrometastases by these markers is difficult with significant reduction in the diagnostic accuracy. S-100 protein demonstrates immunoreactivity for other nonmelanoma cells and obscures nuclear details, which are crucial for the interpretation of single cell metastases. We compared the new melanoma markers, Melan-A (clone A103) and MART-1 (clone M2-7C10), with S-100 protein and HMB-45, by examining 77 formalin-fixed paraffin-embedded sections of sentinel lymph nodes from 13 cases of primary cutaneous melanoma. CD68 (PG-M1) and hematoxylin-eosin-stained sections were also studied. Four pathologists interpreted the staining pattern after concealing the identity of each immunomarker. Az values (area under receiver operating characteristic curve) with receiver operating characteristic curve were higher with Melan-A (0.9742) and MART-1 (0.9779) compared with S-100 protein (0.8034) and HMB-45 (0.8651), demonstrating a higher diagnostic accuracy with Melan-A and MART-1 with superior detection of melanoma micrometastases. Melan-A and MART-1 showed sharp cytoplasmic immunoreactivity, almost exclusively restricted to the melanoma cells. Therefore, Melan-A and MART-1 are recommended for the evaluation of micrometastases in sentinel lymph nodes of cutaneous melanoma as a routine alternative to S-100 protein and HMB-45.

Interactions in recovery and in residual injury from sequential treatments of mouse haemopoietic and stromal marrow cell populations, using X-rays, cyclophosphamide and busulphan.

The acute recovery of populations of day 11 CFU-S, iv-CFC and CFU-F in mouse bone marrow, following a test dose of X-rays, cyclophosphamide (CP) or busulphan (BUS) given to mice previously treated with repeated priming doses of X-rays or CP, was in general predictable from the amount of residual injury after the priming doses. A marked exception was iv-CFC after X-rays, which although amplified to near normal levels during the residual injury phase, recovered after the test irradiation from low levels of CFU-S. The amount of residual injury after sequential treatments of different agents was in general less than expected on the basis of the product of the effects of the individual agents. This was most marked for CP priming treatments, where the long-term recovery of day 11 CFU-S after the test dose remained persistently above control levels. Also, some correlation was found between improved stromal recovery (CFU-F) and the CFU-S content following the sequential treatment protocols.

Sensitive spectrophotometric determination of traces of zirconium with 2-(6-bromo-2-benzothiazolylazo)-5-diethylaminophenol in the presence of sodium lauryl sulphate.

A simple and highly sensitive procedure for spectrophotometric determination of zirconium has been developed. At pH 4.6, zirconium reacts with 2-(6-bromo-2-benzothiazolylazo)-5-diethylaminophenol in the presence of sodium lauryl sulphate to form a red-violet complex, which has an absorption maximum at 520 nm. The molar absorptivity at 520 nm is 4.4 x 10(5) 1.mole(-1) .cm(-1). Beer's law is obeyed for 0.25-1.50 mug of zirconium in 25 ml of solution. The method has been used in the determination of zirconium in aluminium alloy and steel samples.

Efficacy of intravenous lidocaine versus placebo on attenuating cardiovascular response to laryngoscopy and tracheal intubation: a systematic review of randomized controlled trials.

Cardiovascular response to laryngoscopy and tracheal intubation may be harmful in surgical patients with cardiovascular and cerebral diseases. The efficacy of intravenous lidocaine on attenuating the hemodynamic changes remains controversial. This systematic review aims to determine the efficacy of lidocaine versus placebo. PubMed, Embase and Cochrane Library databases were searched for relevant randomized controlled trials (RCTs). The quality of eligible RCTs was evaluated according to the modified Jadad scale. Quantitative analyses were carried out using Review Manager 5 and Stata 10. Thirty-seven trials with 1429 patients of different age groups were included in our meta-analysis. Additional lidocaine resulted in fewer changes in systolic blood pressure (SBP) (mean difference (MD) -4.32 mmHg, 95% confidence interval (CI) -6.21 to -2.43); diastolic blood pressure (DBP) (MD -4.76 mmHg, 95% CI -5.90 to -3.63); mean arterial blood pressure (MAP) (MD -2.72 mmHg, 95% CI: -3.65 to -1.80) and heart rates (HR) (MD -4.28 beats per min, 95% CI -5.83 to -2.72). Subgroup analysis showed that lidocaine was effective in both the elderly and children with the exception of failing to reduce HR in children. Exclusion of poor-quality trials did not change the favor to lidocaine. No significant publication bias across trials was found. Intravenous lidocaine helps reduce cardiovascular responses to laryngoscopy and tracheal intubation in patients of all age groups compared to placebo. Further studies are needed to clarify the effects of dosage and timing of lidocaine on hemodynamic changes.

[A quantitative study on DNA content of salivary gland carcinomas by image analysis technique].

DNA content was quantitatively determined in 30 cases of salivary gland carcinoma (SGC) by image analysis technique using paraffin-embedded sections stained with Feulgen method. The results showed that the nuclear DNA content was related to the malignancy of SGC, based on the clinical and morphological criteria such as tumor size, mobility, property of growth, mitotic rate, degree of differentiation and the histological type of the tumor. The number of nuclei above 5 C DNA, expressing aneuploidy, seems to be of more prognostic significance. Aneuploidy greater than 10% may be indicative of a poor prognosis for SGC. Thus, it is suggested that the quantitative analysis of DNA content may be able to provide an objective and quantitative reference for evaluating the prognosis of SGC.

Functional superficial parotidectomy.

PURPOSE: To clinically test a new type of parotid surgery termed functional superficial parotidectomy (FSP) to preserve the function of the residual gland. PATIENTS AND METHODS: Sixteen human parotid specimens were dissected, and 19 patients underwent FSP. RESULTS: It was shown that 91.4% of the main parotid ducts were found deep to the surface of the facial nerve. Physical examination, sialography, and scintigraphy showed that function of the residual gland was well preserved by FSP. CONCLUSION: A comparison of the main complications between FSP and conservative superficial parotidectomy showed a significant decrease (P < .01) of Frey's syndrome with FSP.

A comparison between the clinical behavior of neurilemmomas in the neck and oral and maxillofacial region.

The records of 49 patients with neurilemmoma in the neck and oral and maxillofacial region (OMR) were reviewed. The results showed some location-related differences in clinical behavior, including six cases of recurrence and two cases of malignant change found in the OMR. It was suggested that anatomic factors play an important role in the poor prognosis of tumors in the OMR.

Congenital extraoral fistula from an auxiliary parotid gland.

A rare case of an auxiliary major salivary gland in the parotid region with an external fistula is reported. Clinical findings and management are described, and relevant embryology and etiology are discussed.

Divergent regulation of 1,25-dihydroxyvitamin D3 on human bone marrow osteoclastogenesis and myelopoiesis.

The physiologically active form of vitamin D3, 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) has influence over osteoclastogenesis and myelopoiesis, but the regulational mechanism is not well-defined. In this report, formation of osteoclast-like (OCL) cells from primitive myeloid colony-forming cells (PM-CFC) as mediated by 1,25(OH)2D3 was examined. Our results present in this report clearly show that 1,25(OH)2D3 dose-dependently stimulated OCL cell formation when added to suspension cultures of individually replated PM-CFC colonies. Marrow cells were plated with either granulocyte-macrophage colony-stimulating factor (GM-CSF) or the human bladder carcinoma cell line 5637 conditioned medium (5637 CM) as the source of colony-stimulating activity. The 1,25(OH)2D3 effect of osteoclast differentiation was associated with a concomitant decrease in clonogenic growth of myelopoietic progenitors in response to colony-stimulating activity. Secondly, the effect of adding the known stimulator of hematopoiesis, interleukin-1beta (IL-1beta) and/or 1,25(OH)2D3 on human myeloid colony growth was assessed. IL-1beta enhanced the formation of primitive myeloid colonies in response to GM-CSF by 160%. On the other hand, 1,25(OH)2D3 dose-dependently inhibited both GM-CSF- and 5637 CM-driven myeloid colony formation by as much as 90% at 100 nM. Addition of IL-1beta to GM-CSF-stimulated cultures dampened the inhibitory effect of 1,25(OH)2D3. The inhibition of myeloid clonogenic growth by 1,25(OH)2D3 was almost abolished (89%) by simultaneously adding anti-tumor necrosis factor-alpha monoclonal antibody (anti-TNF-alpha MoAb) to the culture medium. These results collectively suggest divergent roles for 1,25(OH)2D3 in osteoclastogenesis and myelopoiesis, promoting the differentiation of OCL cells from primitive myeloid cells but inhibiting the proliferation of later myeloid progenitor cells. This inhibition of myeloid progenitors may be mediated by TNF-alpha.

[The comparative study of the ultra-light anaesthesia between N(2)O inhalation and propofol intravenous in tooth extraction]

OBJECTIVE:To study the effect of N(2)O inhalation and propofol intravenous anaesthesia in tooth extraction. METHODS: 40 dental outpatients with the extraction of the mandibular wisdom tooth,ASAI,were randomly allocated to two groups:N(2)O group with the age of 20-36 years old and propofol group with the age of 21-35 years old.All cases undergoing dental extraction were given ultra-light anaesthesia as an adjunct local anaesthesia. RESULTS: The two groups were gained various levels of sedation,there were no significant difference among BP,HR,RR,SPO(2) before,in,and after the operation.Dental treatment could be carried out in cooperating conditin throughout the whole procedure.There was a certain extent of amnesia postoperation,the incidence of postoperative side effects was low,the recovery time was gained within 30 minutes. CONCLUSION: The analgesic effects of N(2)O group were superior to the propofol group.