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Background: Several studies suggest that melanoma may be resistant to treatment because of resistance to apoptosis and that this may be the result of activation of the extracellular signal regulated kinase (ERK1/2) pathway. Aims: To test this hypothesis by examining the expression of ERK1/2 and its activated form in histological sections of melanoma and its relation to known prognostic features of the disease. Materials/Methods: Immunohistochemistry with antibodies to ERK1/2 and phosphorylated ERK (p-ERK) was performed on formalin fixed sections from 42 primary melanomas, 38 metastases, and 20 naevi. Fourteen of the primary melanomas were in the radial and 28 in the vertical growth phase. Results: ERK1/2 was widely expressed (100%) in all the (pigmented) lesions studied. p-ERK1/2 expression was much lower in compound (32.4%) and dysplastic (54.5%) naevi than in primary melanoma (nodular 78.8%, superficial spreading 67%) and subcutaneous metastases (76.3%). p-ERK expression was much lower in lymph node metastases (48.5%), suggesting that the microenvironment may influence the activation of ERK. There was a (non-significant) trend for p-ERK expression to be higher in thick (>1.0 mm) versus thin (⩽ 1.0 mm) melanoma (p = 0.23). There was a trend for overall survival to be related to p-ERK expression in patients with melanoma over 1 mm in thickness. Conclusions: Expression of activated ERK1/2 in melanocytic lesions appears to be related to malignant potential so that activation of ERK1/2 may be important in melanoma progression. These results provide important histological support for the proposal that inhibition of this signalling pathway may be useful in treatment of melanoma. [ABSTRACT FROM AUTHOR]

Presumptive embolic chorioretinal Torulopsis glabrata infection is described in a patient who had received prolonged intravenous antibiotic therapy. The ocular findings are compared and contrasted with embolic lesions due to Candida albicans. The patient was treated for 6 weeks with intravenous miconazole. During this time there was shrinkage of the ocular lesions, some improvement in vision and abolition of fungaemia. Improvement in tests of immune function during treatment suggests that an early immunological deficit was secondary to the infection. Intravenous miconazole is a relatively nontoxic alternative to amphotericin and deserves further evaluation in the treatment of ocular mycosis. [ABSTRACT FROM PUBLISHER]

Assays of lymphocyte subpopulations and function have been performed on patients with acute lymphoblastic leukaemia still in remission after 18 months' treatment. The patients were subjects of a trial of the value of craniospinal irradiation in the third month of treatment in preventing central nervous system relapse. Effects of both irradiation and chemotherapy were observed. Lymphopenia was much more marked in those patients who had received irradiation over a year previously. Assays of response to phytohaemagglutinin (P.H.A.) and staining for surface immunoglobulin indicated that this difference was due to a deficiency in thymus-dependent lymphocytes in the irradiated children. Chemotherapy had a particularly marked depressant effect on lymphocytes with antibody-dependent cytotoxic activity and a proportion of PHA-responsive cells were also depressed. It may be relevant that four of the patients depleted of thymus-dependent lymphocytes by radiation died of infection during remission, while none of those treated with chemotherapy alone died in remission. [ABSTRACT FROM PUBLISHER]