Sabine Reinisch

Induction chemotherapy with docetaxel, cisplatin and 5-fluorouracil followed by radiotherapy with cetuximab for locally advanced squamous cell carcinoma of the head and neck☆

PURPOSE To determine the efficacy and feasibility of induction chemotherapy (ICT) with docetaxel, cisplatin and 5-fluorouracil followed by radiotherapy and cetuximab (C) in patients with locally advanced head and neck cancer. PATIENTS AND METHODS Forty-nine previously untreated patients with local advanced stage III and IV squamous cell carcinoma of the head and neck (SCCHN) received three courses of ICT consisting of docetaxel 75mg/m(2) day 1, cisplatin 75mg/m(2) day 1 and infusional 5-fluorouracil 750mg/m(2)/day on days 1-5 followed by radiotherapy plus C at 250mg/m(2)/week (after an initial loading dose of 400mg/m(2)). RESULTS After completion of ICT 44 of 49 patients received radiotherapy plus C. Three months after therapy completion tumour response was observed in 33 patients and after two years, 25 patients were in complete remission (CR). The most common grade 4 toxicity during the whole treatment period was dermatitis (30%), followed by mucositis (27%) and neutropenia (17%) without fever. One toxic related death was observed during ICT. Two-year progression-free survival (PFS) rate was 59% and two-year overall survival (OS) rate was 63%, respectively. CONCLUSION Concurrent radiotherapy plus C after three courses of ICT was feasible and was associated with promising CR, PFS and OS rates. Further optimisation of dose and sequence is warranted.

The role of interleukin-16 in eosinophilic chronic rhinosinusitis

Eosinophilic granulocytes (Eos) are found in great numbers both in the tissue and in the mucus of patients suffering from chronic rhinosinusitis with polyposis (ECRS). Interleukin-16 (IL-16) is known as a highly potent chemotactic and chemoattractant molecule (ED 10−11) for Eos. In an open, explorative, controlled study we examined the presence of IL-16 in mucosa tissue, mucus and serum in patients suffering from ECRS and its association to Eos activation. Tissue and nasal mucus specimen from 10 previously untreated, non allergic ECRS-patients undergoing paranasal sinus surgery and from 10 healthy non sinusitis subjects, undergoing nasal surgery because of anatomic nasal obstruction were investigated by real-time (RT-) PCR targeting human IL-16 mRNA. Haematoxylin-eosin (HE) staining and immunohistochemistry of formalin embedded tissue and mucus were applied for detection and determination of the proportion of activated Eos (aEos) and IL-16. Serum IL-16 was analyzed by enzyme-linked-immunosorbent assay (ELISA). IL-16 mRNA and IL-16 protein levels were elevated in nasal mucus, polyp tissue and in the serum of ECRS patients compared to healthy controls. There was a high proportion of aEos in ECRS patients compared to healthy subjects. Serum IL-16, IL-16 mRNA expression and IL-16 protein in mucus and tissue specimens were significantly associated with the presence of aEos in polyps of ECRS patients. Immunohistochemically IL-16 protein was mainly expressed in aEos, mast cells, lymphocytes and epithelial cells. In conclusion our data indicate that IL-16 may stimulate the migration and persistence of activated Eos in ECRS. IL-16 production in ECRS patients is not mediated by Immunglobuline-E (IgE).

Course of Maternal Serum Magnesium Levels in Low-Risk Gestations and in Preterm Labor and Delivery

Objectives: To describe the course of total and ionized magnesium and total calcium levels in maternal serum during low-risk pregnancies and to compare women who developed preterm labor and delivery with those who delivered at term. Methods: 209 women with low-risk pregnancies were enrolled in a prospective trial before the 18th week of gestation. No woman received oral magnesium supplementation. The ionized and total magnesium and total calcium levels in maternal serum were measured every 4–6 weeks. The data were grouped into 3 gestational periods (≤18, 19–27 and ≥28 weeks of gestation) for overall comparison and analyzed with the general linear model for repeated measurements and ANOVA. p values of < 0.05 were considered statistically significant. Results: 145 gestations were available for analysis. 27 women were hospitalized for preterm labor and in 16 of these preterm delivery occurred. Ionized and total magnesium and calcium levels were significantly lower after the 18th week of gestation than before. The cation levels in women with preterm labor and delivery did not differ from those with term delivery. Conclusion: Ionized and total magnesium and calcium levels decrease with increasing gestational age. Preterm labor and delivery do not seem to be related to changes in serum cation levels.

Preservation of ipsilateral submandibular gland is Ill advised in cancer of the floor of the mouth or tongue

Preservation of the submandibular gland (SMG) during a neck dissection is gaining popularity and is showing an increasing tendency. The potential benefit, if the SMG is preserved, can be manifold. The aim of this study was to assess the benefit of the preservation of the SMG and the associated risk of recurrent disease in patients with oropharyngeal or oral cavity squamous cell carcinoma.

Influence of histopathologic factors on pattern of metastasis in squamous cell carcinoma of the head and neck

Knowledge of histopathological factors, such as perineural invasion (PNI), extracapsular spread (ECS), angiolymphatic vessel invasion, and conglomerate lymph nodes, in patients with head and neck squamous cell carcinoma is important for appropriate treatment decisions. Given the availability of aggressive therapeutic options with known side effects and burdens for the patient, choosing the correct treatment option is vital.

Influence of Topical Antifungal Drugs on Ciliary Beat Frequency of Human Nasal Mucosa: An In Vitro Study

Topical antifungal treatment is a subject of discussion in the treatment of chronic rhinosinusitis. The aim of this research was to study the effects of antifungal drugs on ciliary beat frequency (CBF) of human nasal mucosa under in vitro conditions.

Contents Vol. 14, 1999

313 14th International Congress ‘The Fetus as a Patient’ New York City, N.Y., USA, April 22–24, 1999 285 Erratum 321 Drs. Haackert Prize 1999 Awarded to Prof. Juri Wladimiroff, The Netherlands Brezinka, Ch. (Innsbruck) 323 Prenatal Orogastric Gene Delivery Results in Transduction of the Small Bowel in the Fetal Rabbit Wu, Y.; Liu, J.; Woo, S.; Finegold, M.J.; Brandt, M.L. (Houston, Tex.) 328 Hemangioma of the Umbilical Cord: Stenotic Change of the Umbilical Vessels Kamitomo, M.; Sueyoshi, K.; Matsukita, S.; Matsuda, Y.; Hatae, M. (Kagoshima); Ikenoue, T. (Miyazaki) 332 Course of Maternal Serum Magnesium Levels in Low-Risk Gestations and in Preterm Labor and Delivery Arikan, G.M.; Panzitt, T.; Gücer, F.; Scholz, H.S.; Reinisch, S.; Haas, J.; Weiss, P.A.M. (Graz) 337 Failure of Amniotic Septostomy in the Management of 3 Subsequent Cases of Severe Previable Twin-Twin Transfusion Syndrome Pistorius, L.R. (Johannesburg/Pretoria); Howarth, G.R. (Pretoria) 341 Serum Enzyme Activities in Premature Infants with Bronchopulmonary Dysplasia Zanardo, V. (Padua); Rizzo, L. (Livorno); Trevisanuto, D.; Simbi, K.A.; Golin, R.; Magarotto, M.; Marzari, F. (Padua) 345 Significance of Echogenic Foci in the Left Ventricle of the Fetal Heart in a Low-Risk Population Jaffe, R. (New York, N.Y.); Cherot, E.; Allen, T.; Glantz, J.Ch. (Rochester, N.Y.) 348 Are Bilateral Fetal Lung Masses Double Trouble? Lipshutz, G.S.; Lopoo, J.B.; Jennings, R.W.; Farrell, J.; Harrison, M.R.; Albanese, C.T. (San Francisco, Calif.) 351 Amniotic Band Syndrome in Triplet Pregnancy Suzuki, S.; Yoneyama, Y.; Sawa, R.; Sinagawa, T.; Hayashi, T.; Araki, T. (Tokyo) 354 Continuous Observation of Nitric Oxide Production in the Fetal Rat Brain during Uteroplacental Ischemia Asakura, H.; Nakai, A.; Yokota, A.; Sekiguchi, A.; Koshino, T.; Araki, T. (Tokyo) 360 Multifetal Pregnancy Reduction and Selective Termination: The Canadian Experience von Dadelszen, P.; Johnson, J.-A.M. (Toronto); Farquharson, D.F.; Wilson, R.D. (Vancouver); Seaward, P.G.R. (Toronto) 365 Cerebellar Hypoplasia: Could It Be a Sonographic Finding of Abnormal Fetal Karyotype in Early Pregnancy? Rosati, P.; Guariglia, L. (Rome) 368 Initiating Extradural Analgesia during Labour: Comparison of Three Different Bupivacaine Concentrations Used as the Loading Dose Harms, C.; Siegemund, M.; Marsch, S.C.U.; Surbek, D.V.; Hösli, I.; Schneider, M.C. (Basel) 375 Abstracts 7th Journées Parisiennes Obstétrico-Pédiatriques, February 5, 1999 378 Erratum 379 Author Index Vol. 14, 1999 381 Subject Index Vol. 14, 1999 No. 5 No. 6