We compared concurrent combination chemotherapy and radiotherapy with surgery and adjuvant radiotherapy in patients with stage III/IV nonmetastatic squamous cell head and neck cancer. Patients with non-nasopharyngeal and nonsalivary resectable squamous cell head and neck cancer were randomised to receive either surgery followed by adjuvant radiotherapy (60 Gy over 30 fractions) or concurrent combination chemotherapy and radiotherapy (66 Gy in 33 fractions). Combination chemotherapy comprised two cycles of i.v. cisplatin 20 mg m À2 day À1 and i.v. 5-fluorouracil 1000 mg m À2 day À1 , both to run over 96 h given on days 1 and 28 of the radiotherapy. A total of 119 patients were randomised. At a median follow-up of 6 years, there was no significant difference in the 3-year disease-free survival rate between the surgery and concurrent chemoradiotherapy (50 vs 40% respectively). The overall organ preservation rate or avoidance of surgery to primary site was 45%. Those with laryngeal/hypopharyngeal disease subsite had a higher organ-preservation rate than the rest (68 vs 30%). Combination chemotherapy and concurrent irradiation with salvage surgery was not superior to conventional surgery and postoperative radiotherapy for resectable advanced squamous cell head and neck cancer. However, this form of treatment schedule with a view to organ-preservation can be attempted especially for those with laryngeal/hypopharyngeal and possibly oropharyngeal disease subsites. The majority of the patients with squamous cell head and neck cancer (SCHNC) present with locally and/or regionally advanced disease and the use of radical surgery and/or radiotherapy in this setting yield low locoregional control rates and 5-year survival rates not exceeding 40%.The administration of chemotherapy and radiotherapy concurrently makes use of the resultant synergistic activity to improve tumour cell kill. This strategy has found success in anal canal carcinoma, allowing high cure rates while obviating the need for radical surgery. Studies carried out in the 1990s using combination chemotherapy with concurrent radiation in SCHNC have shown this treatment approach to be feasible despite the significantly higher toxicity and have produced encouraging results. Adelstein et al in a phase II trial using cisplatin (CDDP) and 5-fluorouracil (5FU) combination with concurrent split-course radiotherapy have reported a 4-year relapse-free survival of 45% and an overall survival of 49% (Adelstein et al, 1993). This when compared retrospectively with a similar patient population treated with radiation alone was shown to be improved. Adelstein next investigated the use of the same combination regimen concurrently with a continuous course of radiotherapy (Adelstein et al, 1994). In 19 patients treated in this fashion, despite significant toxicity, there were no treatment-related deaths. At a median follow-up of 20 months, the projected Kaplan -Meier estimate of locoregional disease control was 92%, with the projected relapse-free survival of 86%. Of significance...

summaryExperiments were investigated on animals' biological tolerance of the copolymers of N-substituted methacrylamides with the monomers which can be considered for uses in the modification of the monomeric backbone. The group of N-substituted methacrylamides is the second one in the series of hydrophilic polymers arranged according to their increasing resistance to hydrolysis, and it follows immediately after the esters of methacrylic acid. Histological analysis has shown that the copolymer of N-ethyl methacrylamide with mebhyl met.hacrylate is the best tolerated polymer of this group. In the case of copolymers with butyl acrylate and butyl methacrylate, in the first days after implantation a stronger and more cellular capsiila was formed, and an inflammation was observed in the surroundings of the encapsulated implant. Starting from day 30, however, no differences are found in the encapsulation, and the result of healingin of all the polymers is always favorable. No cancerogenic effects were observed; calcification was found only sporadically in the case of the copolymer with butyl methacrylate.

The behavior of aqueous solutions of poly [N-(2-hydroxypropyl) methacrylamide], poly(N-ethyl methacrylamide), poly(N-ethyl acrylamide), and poly-(triethyleneglycol monomethacrylate) was investigated and characterized in tests required for synthetic infusion solutions. The above solutions were characterized from the viewpoint of toxicity, pyrogenic properties, antigenic properties, effect on the determination of the blood groups, and effects on hemocoagulation. The elimination from blood circulation was studied on several fractions of the "C-labelled poly[N-(2-hydroxypropyl) methacrylamide] having different molecular weights. It was found that in all tests the properties of the polymers investigated do not depart from the expected behavior.

A novel copolymer that consisted of 3-hydroxyvalerate and 4-hydroxybutyrate, P(3HV-co-4HB), was synthesized in Hydrogenophaga pseudoflava by growing it in media containing gamma-valerolactone and gamma-butyrolactone as a carbon source. The monomer ratio in the copolymer was changed by altering the feed ratio of the two lactones. The cultivation technique was composed of three steps: the first-step for high cell production in Luria-Bertani medium, the second-step for intracellular degrading removal of poly(3-hydroxybutyrate) (P(3HB)), which was formed in the first step, by culturing the cells in carbon-source-free medium, and the final step for accumulation of P(3HV-co-4HB) in a mixed lactone medium. All the P(3HV-co-4HB) copolymers contained less than 1 mol % of 3HB unit. These copolymers were characterized by NMR spectroscopy, differential scanning calorimetry, wide-angle X-ray diffraction, and first-order kinetic analysis of intracellular degradation. The copolymer with an approximately equal ratio of the comonomers was found amorphous. The NMR microstructural analysis showed that the copolymers contained appreciable amounts of 3HV-rich or 4HB-rich chains. The (13)C NMR splitting patterns associated with the four carbons in the 4HB unit of P(3HV-co-4HB) bear close resemblance to those observed in the 4HB unit of P(3HB-co-4HB). The signals arising from the carbons in the 3HV unit of P(3HV-co-4HB) split in a manner similar to those in the 3HB unit of P(3HB-co-4HB). Thus the sequences were assigned by comparing the NMR splittings for P(3HV-co-4HB) with those for P(3HB-co-4HB) and P(3HB-co-3HV). The sequence assignment was further checked by comparing the signal intensities before and after degradation of the copolymers. This was considered reasonable because the H. pseudoflava intracellular PHA depolymerase is more specific to the 3HV unit than to the 4HB unit, which was also confirmed by the higher degradation rate constant for the 3HV unit in the first-order kinetic analysis.

This report describes the use of fine needle aspiration (FNA) cytology to make a rapid diagnosis ofPenicillium marneffeiinfection in an HIV positive patient.Pmarneffeiis a thermally dimorphic fungus that is a mould at 25°C and a yeast at 37°C. It multiplies by fission. It can be easily mistaken for various other infections that are characterised by the presence of histiocytes with phagocytosed yeast cells. In smears the demonstration of yeast cells with a distinctive central septum confirms the diagnosis.