Active forms of vitamin D3, 1 alpha-hydroxyvitamin D3 and 1 alpha,25-dihydroxyvitamin D3, were administered in an open-design study to 40 patients with psoriasis vulgaris in three ways: to 17 patients 1 alpha-hydroxyvitamin D3 was given orally at a dose of 1.0 micrograms/day for 6 months, to four patients 1 alpha,25-dihydroxyvitamin D3 was given orally at a dose of 0.5 microgram/day for 6 months, and 19 patients were given 1 alpha,25-dihydroxyvitamin D3 applied topically at concentration of 0.5 microgram/g of base for 8 weeks. Improvement was observed at the end of the individual study periods in 13 (76%) patients in Group 1 with a mean period of treatment (+/- SD) of 2.7 +/- 0.6 months, in one patient in Group 2 at 3 months after the start of treatment, and in 16 (84%) patients in Group 3 when the chemical was applied for 3.3 +/- 1.2 weeks. No side-effects were observed in any of these trials. These data suggest that psoriasis may respond to active metabolites of vitamin D3 and that abnormalities in vitamin D metabolism or in responsiveness of the skin cells to active metabolites of vitamin D may be involved in the pathogenesis of this skin disease.

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Background. High‐dose rate (HDR) intracavitary radiation therapy for carcinoma of the uterine cervix has gradually found wider acceptance. In 1983, the authors first presented the results of prospective randomized comparative study of HDR versus low‐dose rate (LDR) therapy. In the current study, the final results of this study with a longer follow‐up are presented. Methods. From January 1975 through August 1983, 430 previously untreated patients with carcinoma of the uterine cervix in Stages I‐III were treated with either HDR 60Co therapy or LDR 137Cs therapy at our department. HDR was administered to a total of 259 patients: 32 patients in Stage I,80 in Stage II, and 147 in Stage III. LDR was administered to a total of 171 patients: 28 patients in Stage I, 61 in Stage II, and 82 in Stage III. Results. The 5‐year cause‐specific survival rates of Stage I–III patients treated with HDR were 85%, 73%, and 53%, respectively. The corresponding figures for LDR were 93%, 78%, and 47%, respectively. There was no significant difference between these survival rates. Moderate‐to‐severe complications developed in 10% of the patients treated with HDR and 4% of those with LDR. This difference in the incidence of complications was statistically significant (P = 0.023). Conclusions. Treatment results in terms of cause‐specific survival were equivalent for HDR and LDR treatment. However, the incidence of complications was higher for the HDR group, although within acceptable levels, than for the LDR group.

SUMMARY We analyzed tricuspid regurgitation noninvasively using ultrasonic pulsed Doppler and twodimensional echocardiography in 66 patients in whom tricuspid regurgitation was suspected from routine clinical evaluation. All of the patients also underwent right ventriculography. Ten healthy subjects served as controls.In 62 of 66 patients, the study was adequately performed. In 58 of 62 patients, pansystolic abnormal Doppler signals were detected in the right atrial cavity, and were interpreted to indicate tricuspid regurgitant flow. Two-dimensional echocardiograms in the parasternal four-chamber view demonstrated that the region in which the abnormal Doppler signals were detected was spindle-shaped and extended from the tricuspid orifice toward the right atrial posterior wall parallel to the interatrial septum.The severity of regurgitation was graded on a four-point scale, based on the distance reached by the abnormal signals from the tricuspid orifice toward the posterior wall. For comparison, the right ventriculograms were evaluated on a four-point scale similar to the Sellers classification of mitral regurgitation. The grades by the two methods matched exactly in 36 cases, differed by one level in 23 and by two levels in three. Thus, the two methods showed a good correspondence. Similar results were obtained for the grading based on the area covered by the abnormal signals. We conclude that noninvasive grading of tricuspid regurgitation by ultrasonic pulsed Doppler and two-dimensional echocardiography is practicable.ALTHOUGH tricuspid valve regurgitation can be due to organic disease of the tricuspid valve, it is generally a functional disorder, and frequently occurs after valvular disease of the left heart or in association with congenital heart disease.' Although tricuspid regurgitation is functional, it can adversely affect the hemodynamic state of the patient.2 Thus, methods for assessing the severity of tricuspid regurgitation are needed, but there are none available.)8 Attempts have been made to assess the degree of regurgitation by contrast echocardiography,9' but this method requires the injection of contrast material.The ultrasonic pulsed Doppler technique has proved useful for detecting blood flow disturbances in the right heart." 16 This technique is reported to be sensitive in detecting tricuspid regurgitation. 17-'() In the present study, we analyzed tricuspid regurgitation in detail using ultrasonic pulsed Doppler and two-dimensional echocardiography;2 we specifically evaluated the severity of tricuspid regurgitation. Materials and Methods

The radiologic and histologic findings are presented of the resection of 14 small hepatocellular carcinomas (HCC), less than 2 cm in maximum diameter, after transcatheter arterial chemoembolization (TCE) using iodized oil. The effect of TCE on small HCC depended on the morphologic type of the tumors. When no extracapsular invasion of tumor cells occurred, TCE was extremely effective against encapsulated tumors. However, in nine of the 14 resected specimens, viable tumor cells remained in or around the tumor. The authors suggest that small HCC are not always curable with TCE alone and that a multi-disciplinary approach is necessary for patients with small HCC.