PURPOSE: To elucidate the efficacy of intensive induction and consolidation chemotherapy regimens (Study Group of Japan for Advanced Neuroblastoma [JANB] 85) for patients with advanced neuroblastoma aged 1 year or older. PATIENT AND METHODS: One hundred fifty-seven patients with newly diagnosed advanced neuroblastoma were entered into this study between January 1985 and December 1990. Eligible patients were 12 months old or older with stage III or IV disease. The patients first received six cyclic courses of intensive induction chemotherapy (designated regimen A1) consisting of cyclophosphamide (1,200 mg/m2), vincristine (1.5 mg/m2), tetrahydro-pyranyl Adriamycin (pirarubicin; 40 mg/m2), and cisplatin (90 mg/m2). The patients were further treated with three different consolidation protocols: 3-[(4-amino-2-methyl-5-pyrimidinyl)methyl]-1-(2-chloroethyl)-1-nitrosour ea, dacarbazine, and bone marrow transplantation. RESULTS: Overall survival rates for patients with stage III disease without reference to the consolidation protocols were 80.8%, 76.9%, and 66.3% at 2, 5, and 10 years, respectively. The overall survival rates for patients with stage IV disease were 58.8%, 34.4%, and 28.9% at 2, 5, and 10 years, respectively. There were no statistically significant differences between the three consolidation treatment groups. Patients who did not achieve complete remission (CR) with induction chemotherapy and surgery all died, suggesting that CR is essential for the cure of advanced neuroblastoma. The overall 5-year survival rate of the 24 patients with N-myc amplified stage III and IV disease was 33.3%, and the longest survival time of a relapse-free patient was 103 months. CONCLUSION: The intensive induction chemotherapy regimen used in this study may be of significant value in increasing the CR rate and survival for patients with N-myc amplified and nonamplified advanced neuroblastoma.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

Inflammatory pseudotumor of the stomach: report of a highly infiltrative case with electron microscopic and immunohistochemical studies.

A large, poorly demarcated, elevated lesion over the area ranging from the lower end of the esophagus to the lesser curvature of the cardiac region was examined in a 19 year old woman, and demonstrated an irregular and highly infiltrative proliferation of spindle cells over the full thickness of the gastric wall. Although the spindle cells grew mainly in the submucosa, they penetrated the muscularis propria, leaving intact muscle tissue that formed an irregular, island-like pattern, and reached the subserosa. The cells were identified as myofibroblasts by light microscopy, immunohistochemistry and electron microscopy. The present case is considered to be of an inflammatory pseudotumor due to extremely infiltrative growth of myofibroblasts. This lesion differed from inflammatory fibroid polyp (similarly consisting of proliferating myofibroblasts accompanied by inflammatory cells) in terms of age at onset, tumor size, pattern of cell proliferation and main inflammatory cell component. This report also discusses the relationship between this lesion and a very recently advocated new entity, inflammatory fibrosarcoma of the mesentery and retroperitoneum, which is a tumour closely simulating inflammatory pseudotumor.

Adult↗

PubMedDate not supplied

A case of intra-articular fracture of the knee joint with three layers within lipohemarthrosis by ultrasonography and computed tomography.

We report a case of intra-articular fracture of the knee joint showing three layers within lipohemarthrosis. Sagittal ultrasonography showed three layers (double fluid-fluid level): a superior hyperechoic layer of fat, an intermediate anechoic layer of serum, and an inferior hypoechoic layer of red blood cells. Horizontal computed tomography imaging demonstrated the same three layers. This is the first case of lipohemarthrosis in which three layers of joint effusion were confirmed by both ultrasonography and computed tomography.

Aged↗

PubMedDate not supplied

Incidence of congenital uterine anomalies in repeated reproductive wastage and prognosis for pregnancy after metroplasty.

To discover the exact incidence of congenital uterine anomalies among infertile patients, hysterosalpingography was performed on 1,200 married women with a history of repeated reproductive wastage. Out of 1,200 hysterosalpingographies, 188 revealed congenital uterine anomaly (15.7%). The degree of uterine cavity deformity in the anomalies was evaluated during hysterosalpingography using the X/M ratio. This indicated that the incidence of repeated spontaneous abortion in cases with low-grade anomalies is as high as the incidence among cases with more severe anomalies. A significant improvement in maintaining pregnancy was observed after metroplasty; more than 84% of postoperative pregnancies were successfully maintained, whereas none of the 233 presurgical pregnancies had lasted full term. As a control group, 47 other women with anomalies were randomly chosen, and their subsequent pregnancies were monitored, without metroplasty. Of their pregnancies, 94.4% terminated spontaneously before 12 weeks of gestation.

Abortion, Habitual↗