Differences in evoked EEG by transcranial magnetic stimulation at various stimulus points on the head.

The combination of transcranial magnetic stimulation (TMS) and electroencephalogram (EEG) is an effective tool for investigating the cortical reactivity and the functional connectivity in the brain. In our previous study, we reported a method of removing stimulus artifact during TMS with Sample-and-Hold circuit and EEG activity evoked by TMS could be measured successfully. In addition to this method, independent component analysis (ICA) was also applied to recorded EEG data in order to remove the stimulus artifact from for off-line analysis. By using these methods, short latency ( 15 ms) EEG responses to TMS could be obtained. In this paper, we focused on the propagation of EEG activity elicited by TMS. We observed both the EEG topography and the distribution of the current density over the whole head by changing the stimulus site. When motor cortex was stimulated, the propagation of EEG activity to contralateral hemisphere could be clearly observed. However, when posterior parietal cortex was stimulated, no or less propagation of EEG responses could be recognized. These results suggest that the responses evoked by TMS over motor cortex propagate to contralateral hemisphere along the axon through the corpus callosum.

Ifosfamide, adriamycin and cisplatin (IAP) plus bleomycin (B) combination chemotherapy in patients with recurrent cancer of the uterine cervix.

A combination chemotherapy of ifosfamide, adriamycin and cisplatin (IAP) plus bleomycin (IAP plus B) was used to treat nine patients with recurrent cervical cancer of the uterus. All patients had received conventional radiation therapy with or without hydroxyurea as a potential radiation sensitizer, and seven of them had measurable disease in a previous irradiated field (4 cases) or distant area (3 cases). The tumors included 5 squamous cell carcinomas (non keratinizing: 2, keratinizing: 3), two adenosquamous (including one glassy cell carcinoma), one adenocarcinoma (endometrioid type) and one argyrophil cell carcinoma. All histologic type cancers except argyrophil cell carcinoma responded to IAP plus B treatment. In seven evaluable cases, three complete responses (CR) and 3 partial responses (PR) were recorded (response rate was 85.7%), including 3 responded tumors within previously irradiated pelvic tissue. The median duration of CR was over 7 months and that of PR was 3.5 months. Side effects of IAP plus B were severe in hematologic toxicity (100% of grade 4 leucopenia) but acceptable, permitting five courses of treatments at four week intervals. The results obtained were encouraging, although therapeutic benefits of IAP plus B were not evident in a patient with argyrophil cell carcinoma and the intractable nature of this histologic type cancer in the uterine cervix was again emphasized.

[Approach to the diagnostic colposcopy--a scoring method of colposcopic pattern].

In order to arrive at a final diagnosis of early cervical cancer by colposcopy alone, a colposcopic scoring system was applied to 172 patients with the disease. Each colposcopic pattern was scored from one point (for white epithelium) to 9 (for invasive cancer). The results obtained were as follows; 1) With these scoring criteria, stage 0 cancers were restricted to below 10 points and were characterized colposcopically by white epithelia with gland openings 2) In stage I-a lesion, atypical vessels, punctuation by irregular arrangement of the dots and concentration of abnormal gland openings were usually observed, and these findings were combined with each other to show a more complicated colposcopic pattern reflected in 11 to 18 points of the score 3) Frank invasions were indicated by 19 points or more, and punctuations or mosaics were seldom found in this stage, although the early "I-b" cancer was difficult to distinguish from I-a with this method 4) The diagnoses from this scoring system were identical with the final diagnoses confirmed by surgical methods in 66.7% of stage 0, 59.4% of I-a and 76.5% of I-b.