Stage is a prognostic factor for surgically treated patients with early-stage lip cancer for whom a 'wait and see' policy in terms of neck status has been implemented.

OBJECTIVES: To determine the locoregional control and survival rates (in terms of risk factors) of patients who underwent surgical resection of early-stage lip cancer and for whom a 'wait and see' policy in terms of neck status had been implemented. METHODS: The sociodemographic data, tumour stage, tumour characteristics and histopathological features of 41 patients with early-stage lip cancer were evaluated. Factors predictive of survival and locoregional recurrence were analysed. The five-year overall survival and disease-free survival rates were determined, and the prognostic risk factors were compared. RESULTS: The mean follow-up period was 60.5 months (range, 4-92 months). Age, sex, tumour stage, tumour thickness and volume, and perineural involvement were not predictive of locoregional recurrence or survival. Pathological tumour stage (T1 vs T2) was a prognostic factor for both five-year overall survival (87.3 vs 65.6 per cent, p = 0.042) and disease-free survival (88.6 vs 65.6 per cent, p = 0.037). CONCLUSION: Tumour stage was clearly a major factor affecting the prognosis of surgically treated patients with early-stage lip cancer for whom a 'wait and see' policy in terms of neck status had been implemented.

The dose-dependent neuroprotective effect of alpha-lipoic acid in experimental spinal cord injury.

BACKGROUND AND PURPOSE: Free radical production after spinal cord injury (SCI) plays an important role in secondary damage. The aim of this study was to investigate neuroprotective effects of the powerful antioxidant alpha-lipoic acid (ALA) in a spinal cord clip compression injury model. MATERIAL AND METHODS: Fifty-six Sprague-Dawley rats, weighing between 210 and 300 g, were randomly divided into seven groups. Spinal cord injury was performed by an aneurysm clip placed extradurally at the level of T9. Group 1 (sham) received laminectomy only. Group 2 (control) received SCI; Group 3 received 30 mg/kg of methylprednisolone sodium succinate (MPSS); Groups 4, 5, 6 and 7 received ALA at doses of 50, 100, 150, 200 mg/kg, respectively, via the intraperitoneal route immediately after SCI. The rats were neurologically tested 24 hours after trauma. Spinal cord samples from injury sites were harvested for measurement of lipid peroxidation products and histopathological evaluation. RESULTS: Spinal cord malonyldialdehyde levels of rats in treatment groups decreased after administration of ALA. The difference between the trauma group and groups receiving MPSS-ALA was statistically significant. The difference between the ALA (50, 100, 150 mg/kg) and MPSS groups was insignificant. Group 7 (ALA 200 mg/kg) was excluded from the study because of the possible toxic effect. Alpha lipoic acid and MPSS had similar effects on spinal cord injury in terms of lipid peroxidation, neurological recovery and histopathological changes. CONCLUSIONS: Alpha lipoic acid at a dose range of 50-150 mg/ kg is as effective as MPSS (30 mg/kg) in neuroprotection after SCI. Further, more detailed experimental studies are needed to determine the effects of ALA on the detrimental results of secondary SCI before its use in humans.

Effect of sodium phenytoin concentration on neural tube development in the early stages of chicken embryo development.

Animal and human research has shown that anticonvulsants are teratogens and pose a risk of causing fetal malformations. In various studies, the teratogenic effects of sodium phenytoin (PTH) in several systems have been investigated. Toe and finger, renal, and even facial malformations have been described in the literature. However, there is debate about whether the true risk of teratogenesis is lower or higher than previously reported for PTH. There is also little published information on the effect of this agent on neural tube closure in an embryological model. In this study, 0.1 mL of three different concentrations of PTH solution (mg/mL: 1, 3, 5) or vehicle was applied under the embryonic disc of specific pathogen-free Leghorn chicken embryos after 24 hours' incubation. Incubation was continued until 72 hours of maturation. At 72 hours, all embryos were evaluated macroscopically and microscopically. There were serious neural tube closure defects in the embryos administered large amounts (0.5 mg) of PTH, but doses of 0.1 mg (subtherapeutic concentration for humans) and 0.3mg (therapeutic concentration for humans) produced no statistically significant defects (p=0.05). The difference between the defects in the high concentration group and the other three groups was statistically significant. In our study PTH administered in a strict concentration regimen produced a lower level of neural tube closure-related defects than previously reported.

TDP-43 accumulation in inclusion body myopathy muscle suggests a common pathogenic mechanism with frontotemporal dementia.

TAR DNA binding protein-43 (TDP-43) is found in ubiquitinated inclusions (UBIs) in some frontotemporal dementias (FTD-U). One form of FTD-U, due to mutations in the valosin containing protein (VCP) gene, occurs with an inclusion body myopathy (IBMPFD). Since IBMPFD brain has TDP-43 in UBIs, we looked for TDP-43 inclusions in IBMPFD muscle. In normal muscle, TDP-43 is present in nuclei. In IBMPFD muscle, TDP-43 is additionally present as large inclusions within UBIs in muscle cytoplasm. TDP-43 inclusions were also found in 78% of sporadic inclusion body myositis (sIBM) muscles. In IBMPFD and sIBM muscle, TDP-43 migrated with an additional band on immunoblot similar to that reported in FTD-U brains. This study adds sIBM and hereditary inclusion body myopathies to the growing list of TDP-43 positive inclusion diseases.