Prostate brachytherapy

In recent years there has been an increase in the number of centres, especially in the USA, using prostate brachytherapy as a means of treating localised prostate cancer. Several centres now have medium term follow up data of large numbers of patients treated with this technique suggesting that outcome in terms of tumour control may be comparable to patients treated surgically. This review summarises results from different brachytherapy series and outlines some of the possible advantages of this technique compared with current conventional treatments for localised prostate cancer.     

Variation in hospital rates of intraaortic balloon pump use in coronary artery bypass operations

BACKGROUND: Little is known about regional patterns of intraaortic balloon pump (IABP) use in coronary artery bypass graft (CABG) operations. Our objectives were (1) to identify clinical variables associated with IABP use, and (2) to examine risk-adjusted rates of IABP use for 12 Massachusetts hospitals performing CABG operations. METHODS: We used hospital discharge data to identify 6944 CABG surgical cases. Logistic regression was used to identify clinical variables associated with IABP use, and the resulting multivariate model was then used to risk adjust hospital rates of IABP use. RESULTS: The IABP was used in 13.4% of the CABG surgical cases. The clinical variables independently associated with IABP use were cardiogenic shock, same admission angioplasty, prior CABG operation, cardiac arrest, congestive heart failure, recent myocardial infarction, and urgent admission status. Risk-adjusted rates of IABP use varied widely across hospitals from 7.8% to 20.8% (p < 0.0001). CONCLUSIONS: Hospital rates of IABP use vary considerably in Massachusetts. This practice variation may be related to the persistent uncertainty regarding the precise clinical indications for the IABP in this patient population.     

Pericardio peritoneal window

Transdiaphragmatic approach to the pericarium through the use of the laparoscope is a safe and rapid way to obtain biopsy of the pericardium and create a window. No drainage tubes are needed: pericardial fluid is absorbed by the peritoneum; there is no need for double lumen tubes for one lung ventilation; and the laparoscopy incisions are small and almost painless. Received: 5 December 1997/Accepted: 17 June 1998     

Changes in the activity of sarcoplasmic reticulum fragments and actomyosin isolated from skeletal muscle of thyroxine-treated cats

1. Sarcoplasmic reticulum fragments (SRF) and actomyosin were isolated from skeletal muscle of cats treated either with thyroxine or with placebo tablets, for 5-16 months.2. Ca(2+) uptake and binding by SRF, measured in the presence and absence of oxalate respectively, were reduced by thyroxine treatment.3. Actomyosin from the thyroxine-treated animals underwent ATP-induced syneresis at a faster rate than did that from the controls.4. Syneresis of the actomyosin preparations from controls and treated animals was inhibited to the same extent by EGTA when rates of syneresis were made the same by adjustment of the KCl concentration in the assay media. In contrast, at any given KCl concentration, syneresis of actomyosin from thyroxine-treated animals was inhibited to a lesser extent by EGTA.5. At the end of the isolation procedure, the amount of Ca(2+) remaining in the actomyosin suspension was similar for both treated and control animals.6. It was concluded that the effect of thyroxine on skeletal muscle may be the result of an action on both the sarcoplasmic reticulum and the contractile protein complex.     

Butyrate-induced reversal of herpes simplex virus restriction in neuroblastoma cells

The synthesis of herpes simplex virus (HSV) in mouse neuroblastoma cells (NB, clone 41A3) is restricted. There was a disappearance of infectious virus upon serial passage of infected cells. NB cells treated with sodium-n-butyrate for 24 hr before infection synthesized 200-2000 times more HSV than untreated cells. Infectious center assays demonstrated that the number of cells capable of producing HSV was increased as a result of butyrate pretreatment. Although host protein synthesis was inhibited by HSV infection, viral-induced protein and DNA syntheses were not detected in the absence of butyrate. Cycloheximide blocked the induction of permissiveness by butyrate suggesting that a protein(s) was responsible for allowing HSV synthesis in NB cells. Regulatable host factors involved in HSV replication in neural cells can be studied in the system described.     

Telomerase activity and homozygous deletions of the p16 gene in liver metastases of colorectal carcinoma

目的　研究人大肠癌肝转移肿瘤中端粒酶活性和p16基因异常及其相互关系 ,并探讨其临床意义。方法　采用TRAP银染方法和半定量多重PCR分别检测了 2 4例大肠癌肝转移肿瘤组织包括其中 5例原发大肠癌组织端粒酶活性及p16基因的纯合缺失情况 ,并结合临床病理参数 ,进行统计学分析。结果　本组 2 4例大肠癌肿转移肿瘤组织中检测到 19例端粒酶阳性 ,阳性率为 79 2 %。 5例原发大肠癌均检测到端粒酶活性 ,其中 3例在相应的肝转移组织中也检测到端粒酶活性。端粒酶活性与转移瘤大小、肝内转移灶数目、HBsAg是否伴有肝纤维化无关。在 2 4例转移瘤组织中有 9例标本中检测到p16基因纯合缺失 ,缺失率为37 5 %。 5例原发大肠癌有 2例检测p16基因的纯合性缺失 ,其中 1例患者在原发肿瘤和转移瘤均检测到p16基因的纯合性缺失。p16基因的纯合缺失与端粒酶活性相关。结论　大肠癌肝转移肿瘤中端粒酶活性和p16基因异常对阐明大肠癌转移的生物学行为可能有重要的意义。端粒酶的异常激活和p16基因异常在大肠癌肝转移过程中可能不是早期事件。     

Clinical, brain electric earth map, endothelin and transcranial ultrasonic Doppler findings after hyperbaric oxygen treatment for severe brain injury

Objective　To analyze the effect and mechanism of hyperbaric oxygen (HBO) treatment for severe brain injury (SBI). Methods　Fifty-five patients were divided into a treatment group of 35 patients and a control group of 20 patients. We observed the alterations of clinical, brain electric earth map (BEAM), endothelin (ET) and transcranial ultrasonic Doppler (TCD) findings before and after HBO treatment as well as outcome. Results　In the treatment group, Glasgow coma scale, BEAM and outcome improved after HBO treatment; compared with that of the control group, it showed a significant difference. After one course of treatment, treatment group ET was reduced from 91.24±12.18?ng/L to 68.88±14.37?ng/L (P&lt;0.01); in control group, ET was reduced from 90.78±15.71?ng/L to 83.12±12.22?ng/L, with a statistically significant difference (P&lt;0.05). TCD records of MCA mean velocity (Vm) was reduced from 64.2±4.8?cm/s to 51.6±4.2?cm/s (P&lt;0.01), and a decrease in MCA systolic velocity (Vs) and pulse index (PI) values was statistically significant (P&lt;0.01). Conclusion　HBO treatment can improve the clinical, BEAM and outcome of severely brain injured patients, by decreasing acute stage ET and improving the blood velocity of MCA and decreasing cerebral vascular resistance. HBO treatment can reduce cerebral vascular spasms, cerebral ischemia and hypoxia. One of the important mechanisms of HBO treatment for severe brain injury is the lowering of intracranial pressure.