We treated 2 patients with IgM monoclonal paraproteinemic demyelinating peripheral neuropathy (PPN) with monthly intravenous human immunoglobulin. Both patients had a steadily progressive course in spite of steroid and other immunosuppressive therapy for 3 years before starting the immunoglobulin therapy. Both had a rapid clinical improvement noticeable 5 to 10 days after the 1st immunoglobulin infusion lasting on the average of 3 to 6 weeks. Retreatment caused improvement after each consecutive infusion. There were no significant adverse side effects. High-dose IV human immunoglobulin can be a useful therapy in the treatment of PPN and warrants a large-scale controlled therapeutic trial.

Summary:The study was designed to determine whether the number of CD34 + /CD33 − cells given at autologous peripheral blood stem cell (PBSC) rescue after intensive therapy for cancer was a better predictor of platelet engraftment than the total number of CD34 + cells infused. + / CD33 + cells in the graft (r = 0.332). Engraftment times for platelets and neutrophils were evaluated in 68 patients. There was no significant difference between the times for platelets to reach Ͼ25 × 10 9 /l or neutrophils to reach Ͼ0.5 × 10 9 /l among patients who received Ͼ or Ͻ2 × 10 6 total CD34 + cells or Ͼ or Ͻ1.38 × 10 6 CD34 + /CD33 − cells although the latter was consistently the better predictor. Platelet recovery to Ͼ50 × 10 9 /l and Ͼ100 × 10 9 /l was delayed significantly in patients who received Ͻ1.38 × 10 6 CD34 + /CD33 − /kg infused (P Ͻ 0.02 and P Ͻ 0.05, respectively). The number of CD34 + / CD33 − cells/kg infused was a stronger predictor of platelet recovery than the total number of CD34 + cells infused (P Ͻ 0.05 for platelets Ͼ50 or Ͼ100 × 10 9 /l). Although platelet recovery was delayed significantly in patients who had Ͻ4 × 10 4 granulocyte-macrophage colony-forming units (CFU-GM)/kg infused, the time delay between receipt of PBSCs and availability of the colony counts limits the use of this assay to patients who do not require stem cells to be given immediately. Our data suggest that the number of CD34 + /CD33 − cells given at PBSC rescue provide information about the quality of the graft necessary for long-term platelet engraftment. However, since the percentage of CD34+ /CD33 − cells shows considerable inter-patient variation, measurement of this cell population may be important in patients who experience poor stem cell

Radical prostatectomy continues to play a central role in the management of localized prostate cancer. The majority of patients diagnosed with prostate cancer will undergo radical prostatectomy. A decrease in the morbidity of this surgical procedure has been accomplished through an improved understanding of pelvic anatomy and a greater understanding of the natural history of prostate cancer. Recently, minimally invasive techniques have been applied to radical prostatectomy (laparoscopic prostatectomy) in order to further decrease the morbidity of this operation. What remains to be determined is whether this approach confers the same long term surgical outcomes as the open approach. One method which offers known long term outcomes coupled with decreased morbidity is the radical perineal prostatectomy. The purpose of this paper is to review the criteria for patient selection as well as outcomes of the radical perineal prostatectomy.

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One case of paediatric Ewing's sarcoma and two peripheral primitive neuroectodermal tumourslextra-osseous Ewing's sarcoma were studied for the characteristic t(1l;22) translocation, using a recently described RNA-polymerase chain reaction method (RNA-PCR). PCR products of the expected sizes were obtained from RNA derived from the Ewing's sarcoma and the peripheral primitive neuroectodermal tumours, but not from other paediatric malignancies. Direct sequencing of the RNA-PCR products confirmed the presence of the EWS-FLI-1 fusion transcript. In one case the presence of the translocation was confirmed by cytogenetic analysis. These results highlight the potential use of PCR for the rapid demonstration of diagnostically important tumour specific chromosome rearrangements.