Cisplatin superior to carboplatin in adjuvant radiochemotherapy for locally advanced cancers of the oropharynx and oral cavity.

BACKGROUND AND PURPOSE: The optimal radiochemotherapy regimen for squamous cell carcinoma of the head and neck (SCCHN) is controversial. In most cases, platin-based chemotherapy regimens are used. However, uncertainty exists whether cisplatin or carboplatin is the better choice. This retrospective study compared radiochemotherapy with either cisplatin or carboplatin in patients with locally advanced SCC of the oropharynx and oral cavity. PATIENTS AND METHODS: Concurrent chemotherapy consisted of two courses of cisplatin (20 mg/m(2) on days 1-5 and days 29 - 33; n = 65) or two courses of carboplatin (AUC 1.5 on days 1-5 and days 29 - 33; n = 41). Both regimens were retrospectively compared for locoregional control (LRC), overall survival (OS), and toxicity. Thirteen additional potential prognostic factors were evaluated including age, gender, ECOG performance status, tumor site, histologic grade, T/N category, AJCC stage, year of treatment, extent of resection, interval between surgery and RT, completion of chemotherapy, and radiotherapy breaks. RESULTS: The 3-year LRC rates were 85% in the cisplatin group and 62% in the carboplatin group, respectively (p = 0.004). The 3-year OS rates were 78% and 51%, respectively (p = 0.001). Acute toxicity (mucositis, skin toxicity, nausea/vomiting, renal toxicity, hematologic toxicity) and late toxicity (xerostomia, neck fibrosis, skin toxicity, lymph edema) rates were not significantly different between the two groups. On multivariate analysis, better LRC was significantly associated with cisplatin (p < 0.001), an ECOG performance status of 0-1 (p = 0.001), and an interval between surgery and RT of ≤ 6 weeks (p = 0.001). Improved OS was significantly associated with cisplatin (p < 0.001) and completion of chemotherapy (p = 0.002). CONCLUSION: For adjuvant radiochemotherapy of patients with locally advanced cancer of the oropharynx and oral cavity, cisplatin appears preferable to carboplatin as it resulted in better outcomes without increased toxicity.

Acceptor-photobleaching FRET analysis of core kinetochore and NAC proteins in living human cells.

Faithful chromatin segregation is mediated and controlled by the kinetochore protein network which assembles at centromeres. In this study, the neighbourhood relations of inner kinetochore and nucleosome-associated complex (NAC) proteins were analysed in living human interphase cells by acceptor photobleaching FRET. The data indicate that CENP-U is in close vicinity to CENP-I as well as to CENP-B and that CENP-M is close to CENP-T.

[Functional results after autologous rotational keratoplasty. A retrospective study]. / Funktionelle Ergebnisse nach autologer Rotationskeratoplastik. Eine retrospektive Analyse.

BACKGROUND: Autologous rotational keratoplasty is a therapeutic option in patients with central corneal scars. Its advantage compared to allogeneic procedures is the absence of immunologic destruction. In this retrospective analysis, long-term results are presented. PATIENTS: Since 1988, autologous rotational keratoplasty was performed in 19 patients. The trephine size varied between 7.0 mm and 9.0 mm. Mean follow-up was 7.1+/-4.6 years. RESULTS: In 16 of the patients, the graft center remained clear during the entire follow-up period. Visual acuity improved from 0.25+/-0.16 preoperatively to 0.34+/-0.27 postoperatively with spectacles and to 0.43+/-0.3 with contact lenses. The mean postoperative astigmatism was 6.41+/-3.87 dpt with irregular components in six patients. CONCLUSION: Only a few postoperative graft complications were observed. Especially in patients with a markedly elevated risk for immune reactions (e.g., small infants), autologous rotational keratoplasty is a safe alternative to allogenic procedures.

Coronary heart disease: seven dietary factors.

The dietary factors believed to be linked with the incidence of coronary heart disease are reviewed in the light of evidence with regard to their functional role, either in protection or in promotion. Detailed analysis of the evidence shows that the relations are more complex than the current lipid hypothesis suggests. It is proposed that, in particular, the polyunsaturated/saturated ratio as a measure of the propensity of the diet to influence the incidence of coronary heart disease should be replaced by indices of atherogenicity and thrombogenicity.

Reflections on the origin of optical asymmetry on earth.

The importance of optical purity, which was stressed in an earlier review, is reassessed in the light of recent evidence concerning the optical configuration of amino acids in biological systems. The most significant fact to emerge in recent years that bear on the origin of optical asymmetry is the experimental evidence for the Salam-Weinberg theory. However, the problem remains: is the effect of PNC-interactions too small to be detectable, and if it is so small, can it be of any significance? In view of the contradictory and confusing nature of the evidence on the induction of optical activity, it is suggested that the Bremen Symposium should agree on some experimental protocols.

The origin of optical asymmetry on earth.

The nature of optical isomerism, and the problem of the origin of optical asymmetry in relation to the origin of life are defined. Developments in particle physics, such as the discovery of parity non-conservation in weak interactions and more recently, of neutral currents, are described. Their significance is that there are a number of possible mechanisms whereby the fundamental asymmetry of matter could be reflected in a preference for one enantiomer over the other, and that, contrary to long-established views, optical isomers do not have identical energy contents: the difference, however, is estimated to be very small. Theories regarding the origin of optical asymmetry are classified in a two-dimensional matrix (origin by chance or due to already existing order; susceptible or not susceptible to experimental test). Recent experimental results and theoretical speculations are reviewed, and proposals are made for further experimental work.