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Despite a tendency for rotational abnormalities of the lower leg in children to improve spontaneously over time, some fail to correct and require corrective derotation osteotomy. In this retrospective study, we report the technique and results of the distal transverse tibial and fibular derotation osteotomy with Kirschner-wire fixation performed in 63 limbs of children with cerebral palsy, clubfoot, idiopathic tibial torsion, and myelomeningocele, as well as other less common conditions. There were no significant infections, neurologic complications, delayed or nonunions, or compartment syndromes as a result of the osteotomy. There were three (4.8%) complications, including late fracture (one), cross-union (one), and distal physeal closure (one). We conclude that transverse, same-level, distal tibial and fibular osteotomy fixated with crossed Kirschner wires is a safe, efficient, and effective surgical approach to the treatment of children with tibial torsion in a variety of clinical conditions.

Undifferentiated carcinoma of the salivary glands is a rare disease, the incidence of which is highest among the Inuit of Greenland and North America. It was demonstrated to be closely related to Epstein- Barr virus (EBV) infection. However, the relation of EBV to this tumor has not been studied to any great extent here in Taiwan because of the small number of cases.Twelve cases of undifferentiated carcinoma of the salivary glands from the period 1977-1996 were retrieved from the cancer registry at National Taiwan University Hospital. The clinical data were analyzed retrospectively based on the medical records. Eleven formalin fixed, paraffin embedded tissue sections were used for in situ hybridization with an antisense probe complementary to EBV-encoded RNA 1 (EBER1).Ten of 12 tumors originated from the parotid gland and 2 from the submandibular gland. The patients' ages ranged from 22 to 63 years, with an average of 38.1 years. One patient was lost to follow-up, 2 patients died of metastatic disease, and the remaining 9 patients were all alive and disease free at last follow-up. The actuarial 5-year survival rate was 79.8%. In situ hybridization demonstrated EBER1 in 9 of the undifferentiated carcinomas with lymphoid stroma, but EBER1 was not demonstrated in the other 2 tumors without lymphoid stroma.Undifferentiated carcinoma with lymphoid stroma of the major salivary glands is closely associated with EBV. The mainstay of treatment is surgery and postoperative radiotherapy. The outcomes in this series were good except for two elderly patients who died of rapid and progressive distant metastases.

We evaluated whether the serum soluble interleukin-2 receptor (sIL-2R) may be a parameter to monitor the efficacy of treatment for nasopharyngeal carcinoma (NPC). There were 177 NPC patients and 24 healthy controls. The level of sIL-2R was measured with a sandwich ELISA kit. Higher levels of sIL-2R than for controls were found in NPC patients before treatment and in patients with distant metastasis (p0.001). There was, however, no difference in sIL-2R levels between controls and NPC patients after radiotherapy in relapse-free or in primary relapse. The sIL-2R levels in sequential testing revealed good correlation with clinical response. The sIL-2R levels were found to be elevated when distant metastasis was detected. Two patients had elevated sIL-2R level up to 5 months before clinical detection of metastasis. These results indicate that serial measurements of sIL-2R levels are worthwhile for NPC patients in their clinical course. The sIL-2R level proved to be an adjunct clinical parameter to monitor the efficacy of treatment of NPC.

The purpose of this study is to clarify the relationship between Epstein-Barr virus (EBV) and tumors of the major salivary gland. EBV DNA was detected by polymerase chain reaction (PCR) in parotid secretions in 56% of patients (n = 32) regardless of the presence of tumors in the parotid gland and in tumor tissues in 19% of surgical specimens (n = 21). By Southern blot-hybridization analysis, we found type A EBV in three patients and type B EBV in one patient. In situ hybridization for EBV genome was positive in surgical specimens of salivary glands in 33% of patients (n = 21). Our results suggest that this virus may not play a role in the pathogenesis of most tumors of the major salivary gland. However, two patients with lymphoepithelial carcinoma were found to have a close relationship to EBV as shown by high titers of antibodies in the sera against EBV related antigens by standard immunofluorescent technique and by the presence of many copies of EBV genome in tumor cells using in situ hybridization.

X-ray absorption near-edge structure (XANES) and x-ray excited optical luminescence (XEOL) have been used to study the optical properties of 2,5,8,11-tetra-tert-butylperylene (TBPe) polyhedral crystals with morphology varies from cube to rhombic dodecahedron. Benefit from the high resolution of synchrotron radiation spectroscopy, C 1s to π∗ and σ∗ transitions from different carbon sites in TBPe can be clearly distinguished in the carbon K-edge XANES. XEOL studies reveal that different crystals exhibit multiple emission bands with different branching ratio. It is also found that all the polyhedral crystals exhibit a weak luminescence in the near infrared, which is absent in the powder sample.

Schwannoma, a relatively common tumor of the nerve sheath, rarely involves the foot. A review of the literature disclosed that most reports of schwannoma of the foot were solitary tumors. There has been only one reported case of multiple schwannomas of the foot. We report a case of multiple schwannomas involving both the medial and lateral plantar nerves of the right foot. The patient had been treated for plantar fasciitis for the previous eight years. After excision of one tumor, magnetic resonance imaging (MRI) was used in the diagnosis, revealing four additional tumors. These tumors were also successfully excised and the patient's symptoms relieved. Patients with prolonged intractable pain and tenderness of the foot may require examination by MRI or sonography to search for deep tumors impinging upon the plantar nerves.

Simons et al. (1) were the first to report an association between nasopharyngeal carcinoma (NPC) and HLA antigens in Chinese patients. Expanded studies on 153 patients by Simons et al. (2) showed a borderline increase in HA A2 and Bw46. Simons et al..(3)reviewed the data collected during the Second Asia-Oceania Histocompatibility Workshop with respect to NPC in Chinese. The close linkage disequilibrium between Bw46 and DRw9 in controls was not seen in NPC patients but there was a high frequency of blanks. The HLA profile showed differences between newly diagnosed patients and long-term survivors.

B-protein is an acidic glycoprotein that appears in the serum of cancer patients, although it is not produced by cancer cells. It is not a cell surface antigen but can serve as a biological marker for detecting malignancies and monitoring cancer therapy. From January to August 1987, serum samples were collected from 133 patients with nasopharyngeal carcinoma (NPC) and 19 patients without cancer as the control group. The positive rates of B-protein in NPC patients without distant metastasis (107) and with distant metastasis (26) were 78.5% and 84.6% respectively. The overall positive rate of B-protein in NPC patients was 79.7%, which did not correlate with tumor stage and sex. The positive rate of B-protein in the control group was 5.3%. The difference in positive rates between NPC and the control group was significant (p less than 0.001). The quantitative changes of B-protein did not correlate with the tumor burden of NPC patients. Therefore, B-protein assay is not recommended in monitoring the treatment of NPC.

In order to detect the difference in serum gamma-interferon levels between patients with nasopharyngeal carcinoma (NPC) and normal controls, the reversed passive hemagglutination (RPHA) method was used. Serum gamma-interferon level was determined in 93 patients with NPC, of these, 47 were newly diagnosed, untreated patients. Of the treated patients, 15 had received radiotherapy but were proved later to have distant metastasis. Thirty-one patients had received radiotherapy and survived over 5 years without local recurrence or distant metastasis. Another 47 healthy subjects, age and sex matched with fresh NPC cases, were used as control group. The results revealed that the concentration of gamma-interferon in the serum of neither males nor females showed significant difference (p greater than 0.1). Among the NPC fresh cases, the concentration of gamma-interferon also showed no significant difference in patient serum in either early stages (stages I and II) or later stages (stages III-V) (p greater than 0.1). The serum gamma-interferon level was significantly increased in fresh NPC patients compared with normal controls (p less than 0.05). Concerning the irradiated patients, serum gamma-interferon level was not increased in patients who survived over five years, without relapse, compared with normal controls (p greater than 0.1). However, the serum gamma-interferon level in patients with distant metastasis was higher than in normal controls (p less than 0.05). Also, the serum gamma-interferon level was significantly increased in distant metastatic patients compared with patients without relapse (p less than 0.05).

The E-cadherin/catenin complex plays an essential role in maintaining intimate intercellular associations and is considered to be involved in tumor metastasis and suppressing invasion by cancer cells. We have analyzed the expression of E-cadherin/catenin complex in a series of nasopharyngeal carcinoma (NPC) specimens using immunohistochemistry and immunoblotting. Data are correlated with the patients' clinicopathological parameters, including the clinical stage, presence of intracranial invasion, presence of lymph node or distant metastasis, and histological grading. The E-cadherin/catenin complex is down-expressed in most of the samples examined. Correlation with clinicopathological parameters shows that expression of alpha- and beta-catenin is associated with the occurrence of intracranial invasion.

The sera from patients with nasopharyngeal carcinoma (n = 30), oral carcinoma (n = 22) and laryngeal carcinoma (n = 22) was extracted before treatment. The concentration of circulating intercellular adhesion molecule 1 (ICAM-1), E-selectin and vascular cell adhesion molecule 1 (VCAM-1) was measured by enzyme-linked immunoassay and compared with those from normal subjects (n = 20). The concentration of circulating ICAM-1, E-selectin and VCAM-1 was significantly increased in nasopharyngeal carcinoma. Correspondingly, VCAM-1 and E-selectin were significantly increased in laryngeal carcinoma, whereas only E-selectin was elevated in oral carcinoma. The concentrations of these adhesion molecules did not significantly differ with respect to the early and late stages of these carcinomas. Elevated levels of soluble adhesion molecules in the sera of cancer patients at three different head and neck regions, although appearing to be implicated in these tumour formations, may be unrelated to tumour progression. © 1999 Cancer Research Campaign