Randomised phase II study comparing dose-escalated weekly paclitaxel vs standard-dose weekly paclitaxel for patients with previously treated advanced gastric cancer.

BACKGROUND: This randomised phase II trial compared dose-escalated weekly paclitaxel (wPTX) vs standard-dose wPTX for patients with previously treated advanced gastric cancer (AGC). METHODS: Ninety patients were randomised to a standard dose of wPTX (80 mg m(-2)) or an escalated dose of wPTX (80-120 mg m(-2)) to assess the superiority of overall survival (OS) with a one-sided alpha error of 0.3 and a power of 0.8. RESULTS: The median OS showed a trend towards longer survival in the dose-escalated arm (11.8 vs 9.6 months; hazard ratio (HR), 0.75; one-sided P=0.12), although it was statistically not significant. The median progression-free survival (PFS) was significantly longer in the dose-escalated arm (4.3 vs 2.5 months, HR, 0.55; P=0.017). Objective response rate was 30.3% with dose escalation and 17.1% with standard dose (P=0.2). The frequency of all grades of neutropenia was significantly higher with dose escalation (88.7% vs 60.0%, P=0.002); however, no significant difference was observed in the proportion of patients experiencing grade 3 or more (40.9% vs 31.1%, P=0.34). CONCLUSION: Dose-escalated wPTX in patients with pretreated AGC met our predefined threshold of primary end point, OS (P<0.3); however, it did not show a significantly longer OS. Progression-free survival was significantly better with dose escalation.

[Natural history of intermittent exotropia--statistical study of preoperative strabismic angle in different age groups].

To clarify the natural history of intermittent exotropia, the authors statistically analysed the size of deviations between the initial and the last visit of unoperated intermittent exotropes. In younger patients who were followed for over five years, the magnitudes were almost the same throughout the follow-up periods. A statistical analysis of preoperative strabismic angles in operated cases of different age groups was also done. From comparable studies of the preoperative size of exodeviations in three different age groups, the deviations in distance fixation in adults were apparently larger than in children. We think the size of the deviation in distance fixation tends to increase with aging, but the increase was not so great for the older adult group. However, the size of the deviation in near fixation tended to steadily increase throughout aging, showing statistical significance among all three groups, children, adults in their twenties and thirties, and adults over forty. In the over forty group, the convergence insufficiency type of deviation was present in the majority.

[The effectiveness of the Faden operation on the superior rectus muscle combined with recession of the muscle for the treatment of dissociated vertical deviation].

We made a retrospective study of the effectiveness of the Faden operation on the superior rectus muscle in combination with recession of the muscle for the treatment of dissociated vertical deviation (DVD). A follow-up period of at least one year was required for inclusion in this study. Fourteen patients met this criterion, and two of them had received bilateral surgery. The average preoperative DVD was 31.2 +/- 9.5 delta (range 14 to 45 delta). The surgical procedure was the Faden operation on the superior rectus muscle 11 to 14 mm posterior to its initial insertion in combination with a 2-to 5-mm recession of the muscle, except in one case. The average of the muscle, except in one case. The average hyperdeviation of the operated eyes was 5.6 +/- 11.4 delta (range 0 to 16 delta), and 12 eyes (75%) had satisfactory results (0 to 9 delta) at the last visit. The average reduction of hyperdeviation was 26.5 +/- 11.4 delta (range 8 to 45 delta), The long-term effect of the Faden operation was relatively stable. The hyperdeviation of operated eyes before surgery was clearly larger than that of unoperated eyes at the last visit (p < 0.001).

Bilateral metastatic sclerochoroidal calcification in a patient with hyperparathyroidism.

We present the case of a 39-year-old man with bilateral sclerochoroidal calcification with primary hyperparathyroidism. Both the calcium and parathyroid hormone levels were elevated. Funduscopic examination revealed slightly elevated, multiple yellow lesions in both eyes. Fluorescein angiography showed filling defects of the choroid. Ultrasonography showed elevated, highly reflective lesions, and a computed tomography scan of the globe disclosed sclerochoroidal lesions with high density. We discuss the mechanism of sclerochoroidal calcification.

Does enterohemorrhagic Escherichia coli O157:H7 enter the viable but nonculturable state in salted salmon roe?

An outbreak caused by salted salmon roe contaminated with enterohemorrhagic Escherichia coli O157 occurred in Japan in 1998. Since about 0.75 to 1.5 viable cells were estimated to cause infection, we presumed that O157 might enter the viable but nonculturable (VNC) state in salted salmon roe and consequently that viable cell numbers might be underestimated. Although patient-originating O157 cells could not grow on agar plates after 72 h of incubation in 13% NaCl, they were resuscitated in yeast extract broth, and more than 90% of the cells were shown to be viable by fluorescent staining, suggesting that almost all of them could enter the VNC state in NaCl water. Roe-originating O157 was resistant to NaCl because it could grow on agar after 72 h of incubation in NaCl water, but about 20% of cells appeared to enter the VNC state. Therefore, germfree mice were infected with O157 to examine the resuscitation of cells in the VNC state and the retention of pathogenicity. O157 that originated in roe, but not patients, killed mice and was isolated from the intestine. However, these isolates had become sensitive to NaCl. O157 cells of roe origin incubated in normal media also killed mice and were isolated from the intestine, but they also became transiently NaCl sensitive. We therefore propose that bacterial cells might enter the VNC state under conditions of stress, such as those encountered in vivo or in high salt concentrations, and then revive when those conditions have eased. If so, the VNC state in food is potentially dangerous from a public health viewpoint and may have to be considered at the time of food inspection. Finally, the establishment of a simple recovery system for VNC cells should be established.

Overview and initial results of the very long baseline interferometry space observatory programme

High angular resolution images of extragalactic radio sources are being made with the Highly Advanced Laboratory for Communications and Astronomy (HALCA) satellite and ground-based radio telescopes as part of the Very Long Baseline Interferometry (VLBI) Space Observatory Programme (VSOP). VSOP observations at 1.6 and 5 gigahertz of the milli-arc-second-scale structure of radio quasars enable the quasar core size and the corresponding brightness temperature to be determined, and they enable the motions of jet components that are close to the core to be studied. Here, VSOP images of the gamma-ray source 1156+295, the quasar 1548+056, the ultraluminous quasar 0014+813, and the superluminal quasar 0212+735 are presented and discussed.