Search

The giant cell tumor is considered to be a locally aggressive benign tumor and has a low tendency toward distant metastasis. They are primarily present in the long bone and are rare in the skull. The osteoclast-like giant cells do not demonstrate mitotic activity and contain large numbers of nuclei. Herein, we described a case of giant cell tumor in the temporal lobe. Heterogenous enhancement is shown on CT imaging in solid areas of tumor. The appearance intermediate to high signal intensity on T1-weighted and very low signal intensity on T2-weighted MR imaging were due to the presence of hemosiderin from prior hemorrhage.

The structure, operation, and fabrication of a novel EEPROM/flash cell and array architecture are described. The cell is about half the size of the traditional floating gate tunnel oxide (FLOTOX) electrically erasable programmable read only memory (EEPROM) cell when laid out with the same design rules. This approach has a simple fabrication sequence and requires minimum overhead circuitry rendering it especially suitable for embedded applications. Characterization shows this approach has good retention and has million cycle endurance. Both read and write disturbs are characterized. There are large margins for both types of disturbs. In fact, the data on write disturbs show the disturb margins to be so large that disturb margin can be safely traded off for reduced stress on select transistors.

Rationale: Primary spinal primitive neuroectodermal tumor (PNET) is relatively rare in all age groups, and the prognosis in most cases of spinal PNETs appears to be poor, with a median patient survival of 1 to 2 years. We present a case with recurrent spinal PNET with brain and bone metastases that was successfully treated by multimodality treatment. Patient concerns: A 14-year-old teenage girl had suffered from progressive left upper back pain with bilateral lower legs weakness and numbness for 1 year. After treatment, left neck mass was noted 3 years later. Diagnoses: Initially, magnetic resonance imaging (MRI) showed neurogenic tumor involving intradural extramedullary space of T5-T10. Pathology report showed PNET (World Health Organization grade IV) featuring lobules of neoplastic cells with round regular nuclei, high nucleus-to-cytoplasm ratio, and fibrillary cytoplasm. At the time of tumor recurrence, chest MRI then showed recurrent tumor at T2-T3 level of the epidural space with right neural foramina invasion. Brain MRI showed extensive bilateral calvarial metastases and leptomeningeal metastases in the right frontoparietal regions. Bone scan showed multiple bone metastases. Interventions: T-spine tumor removal and adjuvant radiotherapy (RT) to T-spine tumor bed were performed in the initial treatment. After clinical tumor recurrence, tumor removal was done again. She then received chemotherapy followed by whole brain irradiation with hippocampal sparing with 35 gray in 20 fractions. Outcomes: After treatment, follow-up images showed that the disease was under control. There was no neurological sequela. She has survived more than 7 years from diagnosis and more than 4 years from recurrence to date. Lessons: Multimodality treatments including operation, RT, and chemotherapy should be considered in the initial treatment planning, and salvage chemotherapy was useful in this case.

Intestinal-type adenocarcinoma (ITAC) is a rare tumor, representing possibly 1.4% of all the sinonasal and skull base malignancies. We present a 62-year-old male with cT4bN0M0, stage IVB intestinaltype sinonasal adenocarcinoma who developed right eye blindness due to tumor-compression of the optic nerve. He received surgery and adjuvant radiotherapy at 70 Gy in 35 fractions, which improved his blindness. After 37 months of follow-up, no progression disease or distant metastasis was found. This case is a reminder of the important role radiotherapy plays in the post-operative treatment of sinonasal ITAC patients.

Cancer stem cells (CSCs) are a subset of cancer cells in tumors or established cancer cell lines that can initiate and sustain the growth of tumors in vivo. Cancer stem cells can be enriched in serum-free, suspended cultures that allow the formation of tumorspheres over several days to weeks. Brefeldin A (BFA) is a mycotoxin that induces endoplasmic reticulum (ER) stress in eukaryotic cells. We found that BFA, at sub-microgram per milliliter concentrations, preferentially induced cell death in MDA-MB-231 suspension cultures (EC50: 0.016 µg/mL) compared to adhesion cultures. BFA also effectively inhibited clonogenic activity and the migration and matrix metalloproteinases-9 (MMP-9) activity of MDA-MB-231 cells. Western blotting analysis indicated that the effects of BFA may be mediated by the down-regulation of breast CSC marker CD44 and anti-apoptotic proteins Bcl-2 and Mcl-1, as well as the reversal of epithelial-mesenchymal transition. Furthermore, BFA also displayed selective cytotoxicity toward suspended MDA-MB-468 cells, and suppressed tumorsphere formation in T47D and MDA-MB-453 cells, suggesting that BFA may be effective against breast cancer cells of various phenotypes.

Various clinician-assessed scoring criteria have been used to grade acute radiation dermatitis. However, it is not known whether these scoring criteria correlate with changes in objective skin biophysical parameters and patient-reported symptoms following radiotherapy. We seek to correlate three different clinician-assessed scoring criteria with skin biophysical changes and patient-reported symptoms in breast cancer patients undergoing radiotherapy.A prospective cohort study was performed in a university hospital medical center. The severity of acute radiation dermatitis in 101 breast cancer patients was graded using the RTOG, CTCAE and WHO clinical scoring criteria. We also measured various skin biophysical parameters (skin blood flow, pigmentation, hydration, and pH) by non-invasive techniques before and after radiotherapy. Patient-reported breast symptoms (pain, itching, local heat, and tightness) were evaluated using a questionnaire.The three different clinician-assessed scoring criteria correlated most strongly with changes in cutaneous blood flow following radiotherapy for breast cancer (correlation coefficient 0.70 for RTOG, 0.68 for CTCAE, and 0.50 for WHO). All three scoring criteria also showed moderate correlation with changes in skin pigmentation (correlation coefficients 0.4-0.5), but showed no significant correlation with skin hydration or pH (correlation coefficients0.2). The scoring criteria correlated poorly with patient-reported breast symptoms (correlation coefficients0.3).The three clinician-assessed scoring criteria (especially the RTOG and CTCAE criteria) show strong correlation with cutaneous blood flow measurements, but correlate less well with other skin biophysical parameters and patient-reported symptoms.

The aim of this study was to evaluate the efficacy of helical tomotherapy plus capecitabine as a preoperative chemoradiotherapy (CRT) in patients with locally advanced rectal cancer (LARC). Thirty-six LARC patients receiving preoperative CRT were analyzed. Radiotherapy (RT) consisted of 45 Gy to the regional lymph nodes and simultaneous-integrated boost (SIB) 50.4 Gy to the tumor, 5 days/week for 5 weeks. Chemotherapy consisted of capecitabine 850 mg/m2, twice daily, during the RT days. Patients underwent surgery 6–8 weeks after completion of CRT. Information was collected for patient characteristics, treatment response, and acute and late toxicities. Grade 3/4 (G3+) toxicities occurred in 11.1% of patients (4/36). Sphincter preservation rate was 85.2% (23/27). Five patients (14.3%) achieved pathological complete response. Tumor, nodal, and ypT0-2N0 downstaging were noted in 60% (21/35), 69.6% (16/23), and 57.1% (20/35). Tumor regression grade 2~4 was achieved in 28 patients (80%). After a median follow-up time of 35 months, the most common G3+ late morbidity was ileus and fistula (5.7%, 2/35). The study showed that capecitabine plus helical tomotherapy with an SIB is feasible in treatment of LARC. The treatment modality can achieve a very encouraging sphincter preservation rate and a favorable ypT0-2N0 downstaging rate without excessive toxicity.

Background Cancer of the retromolar trigone is an uncommon head and neck cancer. In this retrospective study, we identified the prognostic factors and evaluated the therapeutic outcomes of patients treated with preoperative radiation therapy (RT), postoperative RT, and RT alone. Methods Between 1971 and 1994, 65 patients with histologically proven epidermoid carcinoma of the retromolar trigone were treated at the Mallinckrodt Institute of Radiology; 10 patients received preoperative RT (30–55.2 Gy), 39 received postoperative RT (46–66.6 Gy), and 15 were treated with RT alone (63–74 Gy). Surgery included 44 composite resections and 7 wide excisions. The minimum follow-up was 5 years. Results The 5-year disease-free survival rates were 90% with preoperative RT, 63% with postoperative RT, and 31% with RT alone. The 5-year disease-free survival rates were 76% for patients with T1 disease, 50% for T2, 72% for T3, and 54% for T4. The 5-year disease-free survival rates were 69% for patients with NO disease, 56% for N1, and 26% for N2. The locoregional recurrence rates were 10% (1 of 10) for preoperative RT, 23% (9 of 39) for postoperative RT, and 44% (7 of 16) for RT alone. On multivariate analysis, the significant factors for disease-free survival were treatment modality (p = .002) and N stage (p = .012); for locoregional control it was treatment modality (p = .046); and for distant metastasis it was N stage (p = .002). The incidence of bone necrosis, soft tissue necrosis, and severe trismus was 12% with postoperative RT, 11% with RT alone, and none with preoperative RT. Conclusions Combination surgery with postoperative or preoperative RT offers better locoregional control and disease-free survival than RT alone for epidermoid carcinoma of the retromolar trigone. Lymph node status significantly influences the disease-free survival and distant metastasis rates. © 2001 John Wiley & Sons, Inc. Head Neck 23: 758–763, 2001.

Hepatic abscesses are being recognized with increasing frequency in immunocompromised patients and those with malignant diseases. Risk factors and treatment for patients with pure fungal abscesses and mixed fungal and pyogenic abscesses have not been well described. A retrospective review of patients with hepatic abscesses was undertaken at The Johns Hopkins Hospital from 1973 through 1993. Eight patients with pure fungal hepatic abscesses and 34 patients with mixed fungal/pyogenic abscesses were identified. Clinical presentation, diagnosis, management, and outcome were analyzed. In the group with pure fungal abscesses, fungemia was predictive of death; four patients in this group died, whereas the remaining four patients who received amphotericin B treatment before the onset of fungemia all survived. In the group with mixed fungal/pyogenic abscesses, 11 patients received amphotericin B, whereas 23 did not. Ten (43%) of these 23 patients died. However, only one of five patients who received more than 1000 mg of amphotericin B died. In patients with hematologic malignancies, who are known to be at risk for fungal infections, amphotericin B treatment should be instituted early. In patients with mixed fungal/pyogenic hepatic abscesses who fail to improve after drainage and broad-spectrum antibiotics, antimycotic therapy should be considered early, before the onset of fungemia.

The role of radiation therapy (RT) for ameloblastoma remains controversial and undetermined due to the rarity of the disease.A case of repeatedly recurrent ameloblastoma with malignant transformation is presented. The clinical course and managements are described.The 63-year-old man had a recurrent ameloblastoma in the left mandible. Five years after the first surgical resection, he underwent 8 more rounds of surgical excision of the recurrent tumors. The malignant transformation occurred and the unresectable tumor invaded the masticator space, parapharyngeal space, and skull base. He received 3-dimensional conformal RT, at the dose of 66 Gray (Gy) in 33 fractions. The ulcerative exophytic mass had regressed gradually. After follow-up of 28 months, the tumor was well controlled.RT seems to be a feasible treatment option for recurrent ameloblastoma with malignant transformation.

We investigated fund operating characteristics that cause fund companies to perform fund exit decisions and at what point of funds’ lifecycles apply to fund liquidation or mergers. We also examined whether extra variable causes an important determinant effect and how fund operating characteristics before and after fund liquidations or mergers change. The empirical results show that: (1) the factors that affect within-family mergers are fund performance and flow from both cross-section and time-series views. The total net assets affect within-family mergers just in a cross-section analysis, not a lifecycle characteristic in a time-series analysis. Moreover, we found that performance volatility also affects exit decisions. The expense ratio and fund age are not the determinants for three type fund exits in Taiwanese onshore funds. (2) For the liquidation, total net assets, flow, performance volatility, and mid-term buy-hold returns have a significantly negative relationship with the fund liquidations from both the cross-section and time-series views. (3) In general, cross-family fund mergers are potentially conducted for strategic considerations rather than based on specific factors. (4) The performance volatility level before and following mergers was substantial and significant for within-family fund mergers; the expense ratio level before mergers was significant greater than following mergers for cross-family fund mergers.

Background As a strong fermentator, Saccharomyces cerevisiae has the potential to be an excellent host for ethanol production by consolidated bioprocessing. For this purpose, it is necessary to transform cellulose genes into the yeast genome because it contains no cellulose genes. However, heterologous protein expression in S. cerevisiae often suffers from hyper-glycosylation and/or poor secretion. Thus, there is a need to genetically engineer the yeast to reduce its glycosylation strength and to increase its secretion ability. Results Saccharomyces cerevisiae gene-knockout strains were screened for improved extracellular activity of a recombinant exocellulase (PCX) from the cellulose digesting fungus Phanerochaete chrysosporium. Knockout mutants of 47 glycosylation-related genes and 10 protein-trafficking-related genes were transformed with a PCX expression construct and screened for extracellular cellulase activity. Twelve of the screened mutants were found to have a more than 2-fold increase in extracellular PCX activity in comparison with the wild type. The extracellular PCX activities in the glycosylation-related mnn10 and pmt5 null mutants were, respectively, 6 and 4 times higher than that of the wild type; and the extracellular PCX activities in 9 protein-trafficking-related mutants, especially in the chc1, clc1 and vps21 null mutants, were at least 1.5 times higher than the parental strains. Site-directed mutagenesis studies further revealed that the degree of N-glycosylation also plays an important role in heterologous cellulase activity in S. cerevisiae. Conclusions Systematic screening of knockout mutants of glycosylation- and protein trafficking-associated genes in S. cerevisiae revealed that: (1) blocking Golgi-to-endosome transport may force S. cerevisiae to export cellulases; and (2) both over- and under-glycosylation may alter the enzyme activity of cellulases. This systematic gene-knockout screening approach may serve as a convenient means for increasing the extracellular activities of recombinant proteins expressed in S. cerevisiae.

The purpose of this study was to assess the usefulness, safety, and efficacy of intra-arterial (IA) infusion chemotherapy for patients with locally advanced oral commissure cancer.Twenty-one patients with stages III and IV squamous cell carcinoma involving the mouth angle were recruited. Methotrexate (MTX; 50 mg/day) was continuously infused into the external carotid artery for a mean period of 8 days, followed by weekly IA bolus of 25 mg MTX for a mean period of 10 weeks.Thirteen patients (62%) achieved a complete response (CR) and 7 patients (33%) had a partial response (PR). At a median follow-up of 69 months, the estimated 1-year, 3-year, and 5-year survival rates of the patients with CR versus PR were 100% versus 57%, 92% versus 43%, and 80% versus 43%, respectively.Our data demonstrate that continuous IA chemotherapy could achieve a competitive acceptable survival rate and improved locoregional control of advanced oral commissure cancer.

Behavior among investors often influences one another. Investors may forego their own rational analysis but instead adopt behavior that is similar to the group. Recently, several studies note that this herding phenomenon (simultaneously trade the same stocks in the same direction) even exists in the behavior of institutional investors (Choe, Kho, and Stulz, 1999; Grinblatt, Titman, and Wermers, 1995; Kyrolainen and Perttunen, 2003; Lakonishok, Shleifer, and Vishny, 1992; Walter and Weber, 2006; Wermers, 1999; Wylie, 2005). There are three theoretical foundations for explaining institutional investor herding. First, in order to maintain or build a reputation when markets are imperfectly informed, managers may ignore their private information and hide in the herd (Brandenburger and Polak, 1996; Prendergast, 1993; Scharfstein and Stein, 1990; Trueman, 1994; Zwiebel, 1995). Second, managers may infer private information from the prior actions of agents (peer-group effects), and optimally decide to act alike (Bala and Goyal, 1998; Fung and Hsieh, 1999; Pound and Shiller, 1989). Third, institutional investors may receive the correlative private information from analyzing the same indicators (Banerjee, 1992; Bikhchandani, Hirshleifer, and Welch, 1992; Block, French, and Maberly, 2000; Froot, Scharfstein, and Stein, 1992; Hirshleifer, Subrahmanyam, and Titman, 1994) or favoring securities with specific characteristics (Del Guercio, 1996; Falkenstein, 1996; Gompers and Metrick, 2001; Payne, Prather, and Bertin, 1999).

For targeted imaging and therapy of hepatocellular carcinoma (HCC), we established a chimeric promoter (EIIAPA) containing alpha-fetoprotein (AFP) promoter and hepatitis B virus enhancer II (EIIA) to control downstream expression of reporter and therapeutic genes.We combined AFP promoter and EIIA to establish a chimeric EIIAPA promoter, then developed a bi-cistronic plasmid vector containing HSV1-tk and luciferase genes controlled by EIIAPA to stably transfect HCC cells. The selective transcriptional activity of EIIAPA was assayed by bioluminescence imaging (BLI) and the function of EIIAPA was determined by in vivo microPET and BLI.The luciferase expression driven by EIIAPA was higher than that driven by AFP promoter in HCC cell lines. EIIAPA-tk induced cytotoxicity was observed only in HepG2 cells. Accumulation of ¹³¹I-FIAU and bioluminescent signal were detected on HepG2 tumors but not in parental tumors. The HepG2 tumors derived from lentiviral-transduced EIIAPA-tk expressing cells accumulated ¹²⁴I-FIAU whereas the ARO tumors did not. The transfected HepG2 tumors expressed adequate EIIAPA-controlled HSV1-TK and the tumor regressed after ganciclovir treatment.The chimeric EIIAPA is a potential candidate promoter for targeted imaging and gene therapy of HCC.

Aim: Multidisciplinary care of patients with chronic kidney disease (CKD) provides better care outcomes. This study is to evaluate the effectiveness of a CKD care program on pre-end-stage renal disease (ESRD) care. Methods: One hundred and forty incident haemodialysis patients were classified into the CKD Care Group (n = 71) and the Nephrologist Care Group (n = 69) according to participation in the CKD care program before dialysis initiation. The ‘total observation period’ was divided into ‘6 months before dialysis’ and ‘at dialysis initiation’. Quality of pre-ESRD care, service utilization and medical costs were evaluated and compared between groups. Results: The mean estimated glomerular filtration rates at dialysis initiation were low in both groups; but the levels of haematocrit and serum albumin of the CKD Care Group were significantly higher. The percentages of patients initiating dialysis with created vascular access, without insertion of double-lumen catheter and without hospitalization were 57.7%, 50.7% and 40.8%, respectively, in the CKD Care Group, and 37.7%, 29.0% and 18.8% in the Nephrologist Care Group (P

This study examines the relationship between initial public offering (IPO) managers' earnings management behavior during lockup (measured with discretionary accruals, DAs) and operating performance following lockup expiration (measured with operating return on assets, OPROAs). Based on a U.S. IPO sample, the results indicate that DAs during lockup are significantly higher than after lockup expiration. In addition, the reversal effect of DAs results in a negative association of DAs in lockup with post-lockup OPROAs. This negative relation is primarily concentrated in small-sized, non-venture backed, high-tech, and hot-market issued IPOs and is consistent with prior findings that such IPO firms have poorer post-issue performance. The overall evidence supports the role of managerial earnings management behavior during lockup in explaining post-IPO operating underperformance.

Scalability and reliability of a split-gate, p-channel flash E2PROM cell (Caywood et al., 2000) which uses channel FN tunneling for program/erase operations have been investigated. Evaluations of the cell after 106 cycles by charge-pumping (CP) and stress induced leakage current (SILC) methods have also been performed. The cell features merged select transistors (MST) in series with a floating-gate transistor. By utilizing an oxide-nitride-oxide (ONO) stack as both gate dielectric of MST and inter-poly dielectric (IPD) film between floating gate (FG) and control gate (CG) of cell, the performance and scalability are improved considerably. The feasibility of scaling down this memory cell into the 0.18mum generation is demonstrated

Background: The objective of this study was to evaluate the relationship of HIF-1a expression and tumor angiogenesis, recurrence/distant metastasis, and its value in the prediction of aggressive behavior of gastrointestinal stromal tumor (GIST). Methods: Paraffin-embedded specimens from 62 patients with GIST were divided into two groups, low risk (n = 31) and high risk (n = 31) according to the tumor size, mitotic count and proliferating cell nuclear antigen (PCNA) index. We investigated the expression of the HIF-1a and analyzed correlation with tumor angiogenesis monitored by expression of vascular endothelial growth factor (VEGF) and tumor microvessel density using immunohistochemical staining. The data were analyzed with c 2 test or Fisher’s exact test and multivariate test. Results: There were statistically significant differences between high risk (29/31; 93.5%) and low risk (8/31; 25.8%) of GIST in high expression of HIF-1a (P < 0.0001). In addition, the incidence of recurrence/distant metastasis was significantly higher in cases of high HIF-1a expression (12/35; 34.3%) than in cases of low HIF-1a expression (1/24; 4.2%)(P = 0.009). Moreover, high VEGF expression (37/43; 86.0%) and microvessel density (30/32; 93.8%) were significantly higher in high HIF-1a expression tumors than in low-expression tumors (P < 0.0001). Conclusions: Our findings suggest that HIF-1a may play an important role in aggressive behavior and tumor angiogenesis in GIST. In addition, high expression of HIF-1a was significantly correlated with tumor recurrence/distant metastasis, so it may provide an ancillary prognostic factor for GIST.

Using C. elegans genetics we identified a new regulator of endocytosis called RME-6. RME-6 is evolutionarily conserved among metazoans and contains RasGAP-like and Vsp9 domains. Consistent with the known catalytic function of Vps9 domains in Rab5 GDP/GTP exchange, we found that RME-6 binds specifically to C. elegans Rab5 in the GDP-bound conformation, and rme-6 mutants display phenotypes that indicate low Rab5 activity. Furthermore, rme-6 interacts genetically with the worm homologue of the known Rab5 exchange factor Rabex-5. However, unlike other Rab5 associated proteins, a rescuing GFP::RME-6 fusion protein primarily localizes to clathrin-coated pits, physically interacts with α-adaptin, a clathrin adaptor protein, and requires clathrin to achieve its cortical localization. In rme-6 mutants transport from the plasma membrane to endosomes is defective, and small 100 nm endocytic vesicles accumulate just below the plasma membrane. These results suggest a mechanism for the activation of Rab5 in clathrin-coated pits or clathrin coated vesicles that is essential for the delivery of endocytic cargo to early endosomes.

The giant cell tumor is considered to be a locally aggressive benign tumor and has a low tendency toward distant metastasis. They are primarily present in the long bone and are rare in the skull. The osteoclast-like giant cells do not demonstrate mitotic activity and contain large numbers of nuclei. Herein, we described a case of giant cell tumor in the temporal lobe. Heterogenous enhancement is shown on CT imaging in solid areas of tumor. The appearance intermediate to high signal intensity on T1-weighted and very low signal intensity on T2-weighted MR imaging were due to the presence of hemosiderin from prior hemorrhage.

Charge retention behavior affected by mobile ions and plasma charging, including charge loss and charge gain, are characterized on a flash cell with different test structures. Meanwhile, the V/sub t/ distribution for a cell array structure test (CAST) array is found to be influenced by program bake and erase bake. The amount of charge loss due to mobile ions for a single cell is around 3 V, which is much worse than the case for CAST arrays, being around 0.6 V. A special feature, charge gain, as much as 0.8 V after UV bake, reveals a wafer radial distribution. An interaction of plasma charging and mobile ions during wafer processing explains this interesting feature. Based on such a proposed physical model, the data retention behavior for various test structures can be well explained.

We tested the relationship between flow-return and flow-fund characteristics relationship under different fund sizes by using quantile regression. We found that insured investors’ purchase-performance is better than non-insured investors. We found that the relationship between fund inflows and fund performance was stronger among the insured investors of both large-scale and small-scale funds than it was among the noninsured investors. In addition, deferred compensation rates also influenced the purchases and redemptions of the insured investors of large-scale funds. The relationship with performance was enhanced as purchase amounts increased.

Objective The authors document changes in the etiology, diagnosis, bacteriology, treatment, and outcome of patients with pyogenic hepatic abscesses over the past 4 decades. Summary Background Data Pyogenic hepatic abscess is a highly lethal problem. Over the past 2 decades, new roentgenographic methods, such as ultrasound, computed tomographic scanning, direct cholangiography, guided aspiration, and percutaneous drainage, have altered both the diagnosis and treatment of these patients. A more aggressive approach to the management of hepatobiliary and pancreatic neoplasms also has resulted in an increased incidence of this problem. Methods The records of 233 patients with pyogenic liver abscesses managed over a 42-year period were reviewed. Patients treated from 1952 to 1972 (n = 80) were compared with those seen from 1973 to 1993 (n = 153). Results From 1973 to 1993, the incidence increased from 13 to 20 per 100,000 hospital admissions (p < 0.01). Patients managed from 1973 to 1993 were more likely (p < 0.01) to have an underlying malignancy (52% vs. 28%) with most of these (81%) being a hepatobiliary or pancreatic cancer. The 1973 to 1993 patients were more likely (p < 0.05) to be infected with streptococcal (53% vs. 30%) or Pseudomonas (30% vs. 9%) species or to have mixed bacterial and fungal (26% vs. 1%) infections. The recent patients also were more likely (p < 0.05) to be managed by percutaneous abscess drainage (45% vs. 0%). Despite having more underlying problems, overall mortality decreased significantly (p < 0.01) from 65% (in 1952 to 1972 period) to 31% (in 1973 to 1993 period). This reduction was greatest for patients with multiple abscesses (88% vs. 44% ; p < 0.05) with either a malignant or a benign biliary etiology (90% vs. 38% ; p < 0.05). Mortality was increased (p < 0.02) in patients with mixed bacterial and fungal abscesses (50%). From 1973 to 1993, mortality was lower (p = 0.19) with open surgical as opposed to percutaneous abscess drainage (14% vs. 26%). Conclusions Significant changes have occurred in the etiiology, diagnosis, bacteriology, treatment, and outcome of patients with pyogenic hepatic abscesses over the past 4 decades. However, mortality remains high, and proper management continues to be a challenge. Appropriate systemic antibiotics and fungal agents as well as adequate surgical, percutaneous, or biliary drainage are required for the best results.

Department of Surgery, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Department of Radiation Oncology, College of Medicine, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Department of Oral and Maxillofacial Surgery, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan

Serum copper levels (SCL) and serum zinc levels (SZJ) were evaluated in 128 patients with nasopharyngeal carcinoma (NPC) of varying stages before, during, and after radiotherapy, and then compared with normal age-matched subjects. Among these patients, there were 119 undifferentiated squamous cell carcinoma, 5 differentiated squamous cell carcinoma, and 4 moderately differentiated squamous cell carcinoma, respectively. Before radiotherapy, SCLs were significantly higher in NPC patients than in normal subjects, but the difference of SZLs was not significant. The ratio of Cu/Zn also showed a significant difference between normal subjects and NPC patients preradiotherapy. Moreover, except stage II, patients with more advanced stages of the disease had more elevated Cu/Zn ratios. During and after the period of radiotherapy, the SCL decreased as compared with the level of preradiotherapy. The Cu/Zn ratio also decreased after radiotherapy but not significant. However, Cu/Zn ratio of expired patients at least 2 yr after radiotherapy did not show the significant decrease in contrast to the alive ones.

A novel p-channel flash electrically-erasable programmable read-only memory (EEPROM) cell, which is programmed/erased via channel Fowler-Nordheim (FN) tunneling, is described in this paper. Channel FN tunneling is a high efficiency and low-power-consumption approach to flash cell operation. High endurance up to 1 M cycles was demonstrated with small window closure. The new flash cell exhibits good reliability which is quite insensitive to disturb or over program. In order to simplify the process, the interpoly dielectric and select gate dielectrics are fabricated using the same oxide-nitride-oxide (ONO) stack during formation of this cell. Hence, this cell shows good potential for achieving simple processing, low power consumption and negligible disturbance during operation.

This study involved seven patients with cerebral radionecrosis following radiation therapy for nasopharyngeal carcinoma (NPC). Their charts were reviewed and the relationship of extracranial malignancies to cerebral radionecrosis was investigated. The radiation dose ranged from 70 to 135 Gy, and the latency was from 6 to 39 months. Two of seven patients died of NPC-related complications during follow-up. The crude incidence of cerebral radionecrosis in patients with NPC was 0.93% in our series. Improvement of symptoms could be achieved by corticosteroid therapy, with or without surgery. In a review of the literature, there were 306 cases of cerebral radionecrosis in extracranial malignancies. The nasopharynx is the most common primary site in cerebral radionecrosis of extracranial malignancies, followed by the scalp and sinonasal tract. The 3-year overall survival rate in our series was 68.57%, as provided by the Kaplan-Meier product limited method. Cerebral radionecrosis in NPC patients should be differentiated from tumor recurrence, in order to apply the appropriate treatment.