Measurement of Cutaneous Inflammation: Estimation of Neutrophil Content with an Enzyme Marker

We examined the hypothesis that myeloperoxidase (MPO), a plentiful constituent of neutrophils, might seve as a marker for tissue neutrophil content. To completely extract MPO from either neutrophils or skin, hexadecyl-trimethylammonium bromide (HTAB) was used to solubilize the enzyme. With this detergent treatment, 97.8 ± 0.2% of total recoverable MPO was extracted from neutrophils with a single HTAB treatment; 93.1 ± 1.0% was solubilized with a single treatment of skin. Neutrophil MPO was directly related to neutrophil number; with the dianisidine-H2O2 assay as few as 104 neutrophils could be detected. The background level of MPO within uninflamed tissue was 0.385 ± 0.018 units per gram of tissue, equivalent to only 7.64 ± 0.36 × 105 neutrophils. In experimental staphylococcal infection, skin specimens contained 34.8 ± 3.8 units MPO per gram, equivalent to 8.55 ± 0.93 × 107 neutrophils. These studies demonstrate that MPO can be used as a marker for skin neutrophil content: it is recoverable from skin in soluble form, and is directly related to neutrophil number. Further, normal skin possesses a low background of MPO compared to that of inflamed skin

Reactivation of chronic hepatitis B infection related to imatinib mesylate therapy

Imatinib (Gleevec, Novartis), an inhibitor of BCR-ABL, platelet-derived growth factor, and KIT receptor tyrosine kinases, is widely used in the treatment of chronic myelogenous leukemia and gastrointestinal stromal tumors. We describe a case of activation of chronic hepatitis B infection associated with imatinib therapy

Survival after induction chemotherapy and surgical resection for high-grade soft tissue sarcoma. Is radiation necessary?

Background: Induction chemotherapy can produce dramatic necrosis in sarcomas - raising the question of whether or not radiation is necessary. This study reviews the clinical outcome of a subset of patients with high-grade extremity soft tissue sarcomas (STS) who were treated with induction chemotherapy and surgical resection bur without radiation. Methods: Nonmetastatic, large, high-grade STS of the pelvis and extremities were treated with intra-arterial cisplatin, adriamycin, and, after 1995, ifosfamide. After induction, oncologic resection and histologic evaluation were performed. Good responders with good surgical margins were not treated with radiation. Results: Thirty-three patients, with a median follow-up of 5 years, were included. Limb salvage rate was 94%. Median tumor necrosis was 95%. Four patients developed metastatic disease with three subsequent deaths. Two local recurrences occurred; both patients were salvaged with reresection and adjuvant external beam radiotherapy, although one died of metastatic disease 10 years later. Relapse-free and overall survival is 80% and 88% at 5 and 10 years by Kaplan-Meier analysis. Conclusions: Intensive induction chemotherapy can be extremely effective for high-grade STS, permitting limb-sparing surgery in lieu of amputation. Radiation may not be necessary if a good response to induction chemotherapy and negative wide margins are achieved. All patients with large, deep, high-grade STS of the extremities should be considered candidates for induction chemotherapy