Virus-directed enzyme prodrug therapy (VDEPT) utilising cytosine deaminase (CD) converts 5-fluorocytosine (5-FC) into the chemotherapy agent, 5-fluorouracil (5-FU), and has entered into a clinical trial for metastatic colon cancer. To improve this system, a replication-deficient adenovirus, containing a bifunctional fusion gene, CD:uracil phosphoribosyltransferase (UPRT), was constructed (AdCDUPRT). UPRT enhances the conversion of 5-FU into its active metabolites, which inhibit DNA and RNA synthesis. In vitro, AdCDUPRT infection of colon cancer cells resulted in a marked increase in sensitisation to 5-FU, compared with AdCD-infected or uninfected cells. The corollary is a ෂ100-fold and ෂ10 000-fold increase in sensitisation to 5-FC in AdCDUPRT-infected cells, compared to AdCD-infected and uninfected cells,

Objective To investigate the recurrence potential of intrauterine adhesions after hysteroscopic adhesiolysis.Design Retrospective observational study.Setting Tertiary university hospital.Population This study included 115 women who had intrauterine adhesions completely separated during hysteroscopic surgery. The treated adhesions were classified into four groups according to their location and extent: Group 1, central type (i.e. intervening space between the adhesions and both lateral uterine sidewalls) at the middle area of uterine cavity; Group 2, central type at uterine cornua; Group 3, cervico-isthmic; and Group 4, extensive if the adhesions were dense with occlusion of part of the uterine cavity other than cervico-isthmic region.Methods Postoperative outpatient hysteroscopic adhesiolysis was scheduled 10-14 days after the initial hysteroscopic surgery and procedures were repeated every 10-14 days until no reformed adhesions were detected. Multivariate logistic regression models were built to examine initial adhesion characteristics and other factors associated with adhesion reformation and need for subsequent outpatient adhesiolysis. Categorical data were compared using Fisher's exact test.Main outcome measures Number of postoperative outpatient hysteroscopic adhesiolysis procedures.Results The location and extent of adhesions according to the allocated group was the only parameter independently related to the number of postoperative outpatient adhesiolysis procedures (P = 0.0004). Women with Group 1 adhesions underwent a lower number of postoperative interventions compared with those with Group 2, 3 and 4 adhesions (P = 0.0355, P = 0.0004 and P = 0.0087, respectively).Conclusions There is an increased likelihood of intrauterine adhesion recurrence when successfully divided adhesions were originally located at the uterine cornua, the cervico-isthmic region or involved a large portion of the uterine cavity.

Two patients presenting with chronic pigmented purpuric dermatosis (CPPD) on the dorsum of both feet were found to show granulomatous inflammation superimposed on the pathological changes of CPPD. Two similar cases have been reported from Japan. The unique clinicopathological features of this group of patients suggest that they have a rare granulomatous variant of CPPD.

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