IMRT in oral cavity cancer

BACKGROUND: Except for early T1,2 N0 stages, the prognosis for patients with oral cavity cancer (OCC) is reported to be worse than for carcinoma in other sites of the head and neck (HNC). The aim of this work was to assess disease outcome in OCC following IMRT. Between January 2002 and January 2007, 346 HNC patients have been treated with curative intensity modulated radiation therapy (IMRT) at the Department of Radiation Oncology, University Hospital Zurich. Fifty eight of these (16%) were referred for postoperative (28) or definitive (30) radiation therapy of OCC. 40 of the 58 OCC patients (69%) presented with locally advanced T3/4 or recurred lesions. Doses between 60 and 70 Gy were applied, combined with simultaneous cisplatin based chemotherapy in 78%. Outcome analyses were performed using Kaplan Meier curves. In addition, comparisons were performed between this IMRT OCC cohort and historic in-house cohorts of 33 conventionally irradiated (3DCRT) and 30 surgery only patients treated over the last 10 years. RESULTS: OCC patients treated with postoperative IMRT showed the highest local control (LC) rate of all assessed treatment sequence subgroups (92% LC at 2 years). Historic postoperative 3DCRT patients and patients treated with surgery alone reached LC rates of ~70–80%. Definitively irradiated patients revealed poorest LC rates with ~30 and 40% following 3DCRT and IMRT, respectively. T1 stage resulted in an expectedly significantly higher LC rate (95%, n = 19, p < 0.05) than T2-4 and recurred stages (LC ~50–60%, n = 102). Analyses according to the diagnosis revealed significantly lower LC in OCC following definitive IMRT than that in pharyngeal tumors treated with definitive IMRT in the same time period (43% vs 82% at 2 years, p < 0.0001), while the LC rate of OCC following postoperative IMRT was as high as in pharyngeal tumors treated with postoperative IMRT (>90% at 2 years). CONCLUSION: Postoperative IMRT of OCC resulted in the highest local control rate of the assessed treatment subgroups. In conclusion, generous indication for IMRT following surgical treatment is recommended in OCC cases with unfavourable features like tight surgical margin, nodal involvement, primary tumor stage >T1N0, or already recurred disease, respectively. Loco-regional outcome of OCC following definitive IMRT remained unsatisfactory, comparable to that following definitive 3DCRT

ウメ PRUNUS MUME SIEB. ET ZUCC. カラ ブンリ サレタCUCUMBER MOSAIC VIRUSワSUBGROUP Iニ ゾクス ガ ケッセイ ガク テキ ニ クベツ サレル

和歌山県紀南地域のウメに発生するウメ葉縁えそ病の罹病株からCucumber mosaic virus(CMV)が分離された。この分離株はウメに単独ではほとんど病徴を生じないが,Prunus necrotic ringspot virus類似ウイルスとの重複感染によって葉縁えそ,黄斑,不稔などの病徴を示した。この分離株(CMV-Um)は,RNA3の塩基配列ではアミノ酸でsubgroupIの分離株(CMV-O, -Y)と94-95%の,またsubgroupII(CMV-m2)とは同様に80%の相同性を示しsubgroupIと考えられた。しかしながら血清学的には,間接ELISA, DAS-ELISAおよび寒天ゲル拡散法のいずれでも,一部にsubgroupI,IIと異なる特異な抗原決定基を持つことが認められ,RNAの塩基配列と血清反応による分類が異なった。Japanese apricot isolate of Cucumber mosaic virus (CMV-Um) was isolated from Japanese apricot (Prunus mume Sieb. et Zucc.) showing leaf margin necrosis and abortion syndrome, together with prunus necrotic ringspot like ilarvirus. Serotype of CMV-Um was shown as neither subg. I nor II by both agar gel double diffusion and ELISA tests. Nucleotide sequence in RNA3 coat protein (CP) coding region of CMV-Um was determined and compared with the previous reports of other CMV-RNA3. Sequence homologies of nucleotides and putative amino acids between Um and subg. I isolates showed 91-93% and 94-95%, respectively. On the other hand, homology between Um and subg. II isolates showed similarly 75-76% and 80%. Hydrophilicity analysis of amino acid sequence, at the regions of high average hydrophilicity of CMV-Um CP indicated 4 amino acids changes in both subgroups in common, suggesting a few amino acids changes caused variation of CMV serotype. In conclusion, CMV-Um belongs to subg. I in sequence but is different from subg. I and II in serotype

Altered Negative Unconscious Processing in Major Depressive Disorder: An Exploratory Neuropsychological Study

Major depressive disorder (MDD) has been characterized by abnormalities in emotional processing. However, what remains unclear is whether MDD also shows deficits in the unconscious processing of either positive or negative emotions. We conducted a psychological study in healthy and MDD subjects to investigate unconscious emotion processing and its valence-specific alterations in MDD patients.We combined a well established paradigm for unconscious visual processing, the continuous flash suppression, with positive and negative emotional valences to detect the attentional preference evoked by the invisible emotional facial expressions.Healthy subjects showed an attentional bias for negative emotions in the unconscious condition while this valence bias remained absent in MDD patients. In contrast, this attentional bias diminished in the conscious condition for both healthy subjects and MDD.Our findings demonstrate for the first time valence-specific deficits specifically in the unconscious processing of emotions in MDD; this may have major implications for subsequent neurobiological investigations as well as for clinical diagnosis and therapy