Retinoblastoma RB94 enhances radiation treatment of head and neck squamous cell carcinoma.

PURPOSE: To assess whether adenovirus-mediated retinoblastoma 94 (Ad-RB94) transgene expression enhances efficacy of radiation therapy (XRT) of human head and neck squamous cell carcinoma (HNSCC). EXPERIMENTAL DESIGN: The HNSCC cell lines (JHU006 and JHU012) were treated in vitro and in a nude mouse xenograft model with Ad-RB94, Ad-DL312 control vector, or untreated as mock control. Cell viability and tumor growth were evaluated and combined RB94/XRT antitumor activity was analyzed by measuring DNA double-strand breaks, apoptosis-associated early DNA fragmentation, and levels of RB-regulated cell cycle progression E2F1 transcription factor. RESULTS: Ad-RB94/XRT resulted in significant HNSCC cell growth inhibition compared with XRT alone or Ad-RB94 alone in vitro and caused significant tumor regression compared with XRT alone and Ad-DL312/XRT in JHU006 and with XRT alone, Ad-DL312/XRT and Ad-RB94 alone in JHU012 in vivo. Neutral comet analysis revealed that DNA damage was significantly elevated in cells treated with Ad-RB94 alone and Ad-RB94/XRT. Tumors treated with Ad-RB94 alone showed a striking increase in early apoptosis DNA fragmentation, and DNA fragmentation was further enhanced with XRT. In addition, levels of E2F1 were up-regulated by Ad-RB94/XRT combination, whereas Ad-RB94 alone did not affect E2F1 levels and XRT alone led to down-regulation of E2F1. CONCLUSIONS: A potent antitumor effect has been observed after Ad-RB94/XRT combination treatment in HNSCC xenograft tumors. Enhanced tumor regression correlated with increased apoptosis. Ad-RB94 treatment enhances the efficacy of XRT through tumor cell sensitization by arresting the cells at the radiation-sensitive G(2)-M cell cycle and via E2F1 up-regulation.

Efficacy of a local anesthetic pain pump in abdominoplasty.

BACKGROUND: Recently, pain infusion pumps for postoperative pain control have gained popularity in many surgical specialties. This investigation was designed to evaluate the efficacy of a local anesthetic pain infusion pump in management of postoperative pain in abdominoplasty patients. METHODS: A retrospective study of 38 abdominoplasty patients with local anesthetic pain pumps and 35 abdominoplasty patients without pain pumps was performed. Pain pumps were loaded with 0.25% or 0.5% bupivacaine and infused at a constant rate of 4 ml/hour. All patients were admitted postoperatively and started on a narcotic patient-controlled analgesia. Postoperative patient-controlled analgesia narcotic use and pain scores were recorded every 2 hours by the nursing staff. For the first 24 hours of postoperative hospital stay, pain medication, pain scores, and antiemetic use were determined from the patients' charts. Hospital stay was also reviewed. RESULTS: In the pain pump group, there was a small but not statistically significant reduction in pain medication use (2.65 versus 3.04 pain units) (p = 0.34). Interestingly, pain scores were higher in the pain pump group but not significantly (2.73 versus 2.31) (p = 0.17). There was no statistically significant difference in the use of antiemetics (0.8 versus 0.6) (p = 0.60). Hospital length of stay averaged 2.2 days in the pain pump group and 2.5 days in the group without pain pumps (p = 0.09). CONCLUSIONS: The postoperative use of pain pumps in abdominoplasty patients does not significantly improve pain management. Further investigation into this application of the pain pump is necessary before recommending their routine use in abdominoplasty patients.

Management of Hematoma of the Wrestler's Ear.

Hematoma of the auricle may produce ear deformity. The hallmarks of the surgical treatment are thorough evacuation with incisions through the skin and perichondrium, and subsequent compression of the auricle.