Scrotal disorders: evaluation of testicular enhancement patterns at dynamic contrast-enhanced subtraction MR imaging

PURPOSE: To evaluate testicular enhancement patterns in various scrotal disorders at dynamic contrast medium-enhanced subtraction magnetic resonance (MR) imaging. MATERIALS AND METHODS: Forty-two patients with scrotal symptoms (22 testicular diseases, 20 extratesticular scrotal disorders) underwent three-dimensional (3D) fast field-echo or fast spin-echo dynamic subtraction MR imaging after injection of paramagnetic contrast medium. The relative percentages of peak height and mean slope of the testes on the affected side were compared with those on the unaffected side by using time-signal intensity curves. RESULTS: Extratesticular scrotal disorders (time-signal intensity curve mean peak height, 93.1%; mean slope, 89.8%) showed gradual and progressive increase in homogeneous testicular contrast enhancement in all normal testes. Relative percentages of peak height and mean slope of testicular torsion (mean peak height, 17.3%; mean slope, 10.6%), infarction (mean peak height, 30.4%; mean slope, 19.8%), traumatic hemorrhagic necrosis (mean peak height, -3.5%; mean slope, -12.0%), and epidermoid cyst (mean peak height, -6.6%; mean slope, -14.2%) were significantly lower than those of extratesticular scrotal disorders. Acute mumps orchitis (mean peak height, 135.1%; mean slope, 307.5%) and malignant testicular tumor (mean peak height, 178.7%; mean slope, 467.6%) showed higher relative percentages of peak height and mean slope. CONCLUSION: Dynamic contrast-enhanced subtraction MR imaging can provide information about testicular perfusion on the basis of contrast enhancement and can be used to differentiate testicular diseases from scrotal disorders.     

Salvage radiotherapy for biochemical recurrence after radical prostatectomy

OBJECTIVE: To evaluate the clinical outcome of salvage radiotherapy (RT) for biochemical recurrence after radical prostatectomy (RP) at our institution. PATIENTS AND METHODS: Between March 1999 and January 2004, 37 patients had salvage RT for prostate-specific antigen (PSA) failure after RP, including eight who had had neoadjuvant hormone therapy. After surgery, PSA was measured with ultrasensitive immunoassays. In all patients RT was delivered to the prostatic bed at a total dose of 60 Gy with a four-field box technique. RESULTS: The median (range) PSA level before salvage RT was 0.146 (0.06-3.216) ng/mL and RT was started at a PSA level of <0.5 ng/mL in 34 of the 37 patients (92%). With a median follow-up of 31.9 (0-69.8), months, 11 patients (30%) had disease progression after RT and the 3- and 5-year progression-free probability was 74% and 54%, respectively. Univariate analysis showed that clinical and pathological tumour stages and PSA level before RT (>0.15 vs < or = 0.15 ng/mL) were significant predictors of disease progression. There were no late adverse events related to RT. CONCLUSION: Salvage RT for biochemical failure after RP at a low PSA level, using ultrasensitive immunoassays for monitoring, is a reasonably effective treatment. A relatively low radiation dose (60 Gy) seems to be effective.     

Comparison between the psychophysical scale methods for magnitude estimation and category estimation of nurses' social perception

This experiment aimed to rank nurses' social perception through the magnitude and category estimation methods. Study participants were high school and university students, active and retired professionals in the areas of medicine, psychology, nursing and dentistry. The results showed: (1) the characteristics neat, responsible, clean, careful and efficacious occupied the first positions in terms of nurses' social perception; whereas the characteristics useless, dishonorable, irresponsible and hateful occupied the last positions in the scales obtained by the two direct psychophysical methods, and (2) the non-metric social perception continuum has prosthetic characteristics.     

Feeding responses to mu-, delta- and kappa-opioid receptor agonists in the meat-type chick

The present study was designed to examine the effect of specific opioid agonists on feeding behavior in neonatal chicks. The food intake of broiler chicks was significantly decreased by intracerebroventricular injection of DAMGO and beta-casomorphin, micro-opioid receptor agonists, at 30-min postinjection. In contrast, both delta-opioid receptor agonists (DADLE and DPDPE) stimulated the food intake of the chick. Similar to the delta-opioid receptor agonists, food intake was elevated by the kappa-opioid receptor agonist (U-50488H and U-62066) in a dose-dependent manner. These results suggest that the endogenous opioid peptides have an important role for feeding behavior in the central nervous system of chicks.     

Effects of pioglitazone on metabolic control and blood pressure: a randomised study in patients with type 2 diabetes mellitus

AIM: This Swiss multicentre study examined the efficacy and safety of oral pioglitazone in patients with type 2 diabetes. METHODS: Patients were randomised to pioglitazone at once-daily doses of 30 mg for 20 weeks (n = 76), 30 mg for 12 weeks followed by 45 mg for 8 weeks (n = 74), or 45 mg for 20 weeks (n = 84); 94.9% of patients completed 12 weeks and 88.9% completed all 20 weeks. Almost all (96.6%) patients received pioglitazone in combination with other anti-diabetic treatments. RESULTS: Mean HbA(1c) at baseline was 8.8 +/- 1.2%, and changes to endpoint were -1.1 +/- 1.1%, -1.1 +/- 1.4% and -0.9 +/- 1.6%, respectively for the three dose groups ( p < 0.001 for each group). Triglyceride concentrations decreased in each group and the overall mean change during the study was -0.58 mmol/l (p < 0.001 versus baseline). HDL-cholesterol increased, with an overall mean change of 0.10 mmol/l (p < 0.001 versus baseline). Blood pressure decreased from baseline, particularly for hypertensive patients with mean changes: systolic -10 mmHg, p < 0.001, diastolic -8 mmHg, p < 0.001 versus baseline. Serum alanine aminotransferase and gamma-glutamyl transferase concentrations were significantly (p < 0.001 for each) reduced during the study. CONCLUSIONS: The study demonstrates the efficacy of pioglitazone 30 mg/day and 45 mg/day in the treatment of type 2 diabetes, with an improved lipid profile and decreased blood pressure in addition to improved glycaemic control.