ABSTRACT
Significant differences exist between the European and North American treatment protocols for Wilms' tumor and neuroblastoma. There are variations in biopsy technique, timing and extent of initial surgery, chemotherapy protocols and dosage routines, as well as the type of salvage therapy. With the consolidation of the two major North American study groups into a single entity (Children's Oncology Group), the European and North American study groups represent the only remaining large-scale venues for treatment comparison. It is important to study and understand the variation in treatment protocols in order to maintain an open forum of scientific investigation that will lead to improving the care and outcome of children with cancer. It is anticipated that the unification of the North American groups will lead to greater interest and scientific cooperation with the European study group. This paper will serve as a forum for such a discussion at a local level.
Subject(s)
Kidney Neoplasms/diagnosis , Kidney Neoplasms/therapy , Neuroblastoma/diagnosis , Neuroblastoma/therapy , Wilms Tumor/diagnosis , Wilms Tumor/therapy , Clinical Protocols , Europe , Humans , North AmericaABSTRACT
In the rat sphincter pupillae, as in other smooth muscles, the primary signal transduction cascade for agonist activation is receptor --> G protein --> phospholipase C --> inositol trisphosphate --> intracellular Ca(2+) concentration ([Ca(2+)](i)) --> calmodulin --> myosin light chain kinase --> phosphorylated myosin --> force development. Light stimulation of isolated sphincters pupillae can be very precisely controlled, and precise reproducible photomechanical responses (PMRs) result. This precision makes the PMR ideal for testing models of regulation of smooth muscle myosin phosphorylation. We measured force and [Ca(2+)](i) concurrently in sphincter pupillae following stimulation by light flashes of varying duration and intensity. We sampled at unusually short (0.01-0.02 s) intervals to adequately test a PMR model based on the myosin phosphorylation cascade. We found, surprisingly, contrary to the behavior of intestinal muscle and predictions of the phosphorylation model, that during PMRs force begins to decay while [Ca(2+)](i) is still rising. We conclude that control of contraction in the sphincter pupillae probably involves an inhibitory process as well as activation by [Ca(2+)](i).