To improve locoregional control and overall survival, we performed chemoradiotherapy (CRT) for 70patients with head and neck cancer at Kansai Medical University during two year between September 1999and August 2001.
The 70 patients with these cancers were divided into two groups; one was a non-operative group (43patients) and the other was an operative group (27 patients). The patients in the non-operative group received only CRT (60-70 Gy of total radiation dose and two courses of chemotherapy) without surgery. The patients in the operative group received CRT (40 Gy of total radiation dose and one course of chemotherapy)prior to operation.
The results of CRT indicated 83.7% of the response rate (RR), and 48.4% of the complete response rate (CR) in non-operative group.
The results of CRT indicated 92.6% of the response rate (RR), and 14.8% of the complete response rate (CRt) in operative group.
Locoregional control rate in the non-operative group was 41.9%, the other hand, that in the operative group was 88.9%. We speculate that additional operation to the CRT increases locoregional control rate. Overall survival in non-operative group was 90.6%,83.0% at one year,1.5 year, respectively.
Overall survival in operative group was 96.3%,70.2% at one year,1.5 year, respectively. The survival rates between two groups were not significant difference.
Although adverse reactions of CRT on the patients included mucositis leukopenia thrombocytropenia and dermatitis, the symptoms were ranged within grade 3.

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We have been analyzed the T cell subsets in brain tumor patients using by flow cytometry (FCM) and studied intracellular cytokine, such as interferon-γ, and interleukin-4. These cytokine were acummulated with newly developed Brefedin-^αand β were analyzed the positive rates of IFN-γ(Th1), IL-4(Th2), and Th1/Th2 ratio by FCM. Twenty-eight brain tumor patients, such as 15 cases of malignant astrocytoma,10 cases of metastatic brain tumors, one case of malignant lymphoma and 2cases of germinoma were analyzed.
Normal range of IFN-γ was 69.0±11.6%, IL-4 was 2.61±0.92%, and Th1/Th2 ratio was 14.15±6.84%.
Time different of the IFN-γ/IL-4 for 2 days and age different were not recognized. The ratio of malignant astrocytoma and metastatic tumors was tendency to be decreased and all cases of malignant lymphoma and germinoma were definitely decreased.
These results suggested that IFN-γ/IL-4 was influenced with the general and immunological status, and treatment in brain tumor patients.

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This article presents 167 cases of pediatric brain tumors, which were studied in 20 years from 1982 to 2002 at Kanagawa Children's Medical Center (KCMC).
These tumors are histologically classified, and are compared with the previous reports. The tumors in children less than 1 year old (congenital brain tumors) are in 37 cases, which account for 22.2 % of all these tumors in KCMC. The number of congenital brain tumors is similar to the previous reports but more frequent than ones in Yamaguchi prefecture. The distribution of the histopathology of 167 case is not so different from the previous reports and one of the Yamaguchi. But the number of meningiomas is rather conspicuous. Choroid plexus tumors are prominent in the congenital tumors in KCMC.

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A infant case of“xanthomatous”meningioma was examined by light and electron microscopy as well as immunohistochemistry. All tumor cells expressed vimentin and KP-1, Showing granulovacuolar pattern. EMA was also demonstrated under antigen-retrieval. Ultrastructure of tumor cells revealed primitive meningothelial cells containing lipid-droplets.
Xanthomatous meningiomas are reviewed and discussed here.

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Hematopoietic brain tumors were classified with malignant lymphoma, plasmacytoma, granulocytic sarcoma and others by WHO classification of central nervous system tumor. The incidence of these tumors werc rare and showed the simillar round cells without paticular pattern. These tumors were difficult to diagnose by H&E stain, but malignant lymphoma was stained with LCA and CD20, and plasmacytoma made a possible to differential diagnosis by Ig stain.
We tried to study these hematopoietic brain tumors by electronmicroscopy and clear the each characteristic ultrastructural features. Observation of electronmicroscopy study for hematopoietic tumors could be useful to make a definite pathological diagnosis.

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The author presented a story how he had found and named“clear cell ependymoma (CCE).”It happened in 1982 when a 22 years old man was operated for a right frontal tumor. The initial pathologic diagnosis was oligodendroglioma, which was not satisfactory for the author because the the tumor was well enhanced in CT scan. After looking many times of the specimen by microscope, the author found a limited portion where tumor cells arranged around blood vessels and extended their processes toward blood vessel walls. Then done was the immunostain for GFAP and electron microscopic examination which revealed glial and epithelial nature of the tumor cells. The second case of CCE originated from the cerebellum of which the initial diagnosis was hemangioblastoma. The case was presented with interesting episodes. Finally, the author stressed the significance of CCE in cases when the tumor tissue consists mostly of clear cells. Antigen retrieval of EMA in the course of pathologic diagnosis is strongly recommended.

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Immunohistochemical methods are widely used for estimating growth potential and malignancy of brain tumors. Bromodeoxyuridine labeling index (LI) is the most classical one. MIB-1 immunohistochemistry is now the most popular method. An antibody against topoisomerase II-alpha also has become familiar. Cell proliferation kinetics was determined not only by growth fraction but also by cell cycle time and cell loss. Immunohistochemical methods measure a parameter related to the growth fraction. In untreated tumors, they are of value to predict the growth speed since the mean cell cycle time in individual tumor cells and cell loss rate may be relatively constant, or may change tightly coupling with growth fraction. However, when a tumor is treated with irradiation or chemotherapy, cell loss may become prominent and cell cycle time prolongs. In this situation, immunohistochemical methods are no longer reliable. The degree of over-estimation varies among the proliferation markers depending on the phase of cell cycle arrest or prolongation.

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Immunohistochemical cell kinetic analysis of brain tumors is performed with double labeling with BUdR in situ and IUdR in vitro. Double labeling study revealed mostly regular period of S-phase time among the various types of brain tumors as nine to 10 hours, and potential doubling time is varied in tumors, and well correlated with BUdR labeling index. The method will facilitate strategies of post-operative therapy and clinical follow-up.

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