Predictors of weight loss during radiation therapy

OBJECTIVE: To define risk factors for weight loss or dehydration during radiation therapy (RT). STUDY DESIGN AND SETTING: Retrospective chart review, academic tertiary care center. RESULTS: The incidence of severe weight loss during RT was 32.7%, the incidence of dehydration was 10.9%, and the rate of prophylactic feeding gastrostomy tube placement was 32%. The patients most likely to suffer severe weight loss included patients with tumor sites of nasopharynx and base of tongue, those treated with chemoradiation, and patients with severe pretreatment weight loss. Prophylactic feeding gastrostomy tube placement before RT significantly reduced the incidence of severe weight loss and hospitalization during RT. CONCLUSION: Severe weight loss and dehydration during RT for head and neck cancer is common. Prophylactic feeding gastrostomy tubes significantly reduce the incidence of severe weight loss and hospitalization for dehydration during RT when placed before onset of RT. Patients at risk for severe weight loss include those with severe pretreatment weight loss, tumors of the nasopharynx and base of tongue, or treatment with chemoradiation.     

CRYOGLOBULINEMIA AND CUTANEOUS LEUKOCYTOCLASTIC VASCULITIS WITH HEPATITIS C VIRUS INFECTION

Background. Mixed cryoglobulinemia (MC) is a systemic disorder, characterized by a typical clinical triad: purpura, weakness, and arthralgias, with visceral complications such as liver and renal involvement. The objective was to study the association between hepatitis C virus (HCV) infection and essential mixed cryoglobulinemia (EMC). Patients and Methods. Markers of HCV infection in 11 patients with cryoglobulinemia were examined and hepatitis C virus (HCV) was detected in eight of them. These patients were included in a clinical and histologic study. Anti-HCV antibodies were determined by a second-generation enzyme-linked immunosorbent assay (ELISA-2) in sera and cryoprecipitates. Studies on HCV-RNA were performed by a two-stage polymerase chain reaction (PCR) in the serum. A control group, consisting of 28 patients with other cutaneous disorders, was studied for HCV infection using ELISA-2 and PCR. Results. All patients had liver dysfunction, arthralgias, and purpura. Three patients had involvement of the peripheral nervous system, two had renal involvement, and one patient had Sjögren's syndrome. Cryocrits ranged from 3% to 20%. Six patients had type III cryoglobulinemia and the remaining two had type II. Markers for hepatitis B virus (HBV) were negative in all serum samples. Anti-HCV antibodies and HCV-RNA were positive in the serum of all the cases with MC. Anti-HCV antibodies were positive in all cases except for one of the cryoprecipitates tested. Four patients received recombinant interferon alfa. In two of them, serum aminotransferases became normal and cryoglobulins disappeared. Conclusions. The results strongly suggest that HCV infection is responsible for the cryoglobulinemia and vasculitis in patients with MC and that treatment with interferon alfa is presently the treatment of choice for such patients.     

Selective delivery of chemotherapeutic agents with a new catheter system

A new catheter system was used in ten patients (16 infusions) for infusion of chemotherapeutic agents to the sites of malignant gliomas. Thirteen infusions to the supraophthalmic region were successful, as were three infusions to the posterior cerebral region. There were no complications after the infusions. A neurologic complication occurred in one patient in whom two successful supraophthalmic infusions were previously carried out. In this patient the guide wire separated during catheter placement into the posterior cerebral artery.     

应用双向电泳技术初步建立人精子头部蛋白质图谱

目的 :利用人类精子蛋白质组分析的双向蛋白电泳 (2 DE)技术建立正常人精子头部蛋白质图谱。　方法 :先用固相pH梯度 SDS电泳技术 (IPG DALT)对全精子和精子头部蛋白质抽提物进行蛋白质分离 ,然后用图像分析软件比较精子头部蛋白质图像与精子蛋白质图像的蛋白质斑点组成差异。其中 ,全精子蛋白质的抽提比较了硫脲 /尿素 /盐酸胍和Kit/盐酸胍两种抽提方法。　结果 :硫脲 /尿素 /盐酸胍法与Kit/盐酸胍法所得的全精子 2 DE图像蛋白质斑点分别为 80 2个和 797个 ,其中相同的有 4 92个 ,将两种方法获得的图像整合而得到的全精子蛋白质图像有1 1 0 7个蛋白质斑点 ;精子头部图像蛋白质斑点有 4 2 8个 ,经匹配 ,全部来源于全精子蛋白质图像。　结论 :综合采用两种蛋白质提取方法初步建立了精子头部蛋白质图谱。     

Written Simulation of Patient-Doctor Encounters. 1. Research Instrument for Registration of the Performance of General Practitioners

A written simulation of patient-doctor encounters is described,involving five patients with vague complaints, an ‘instruction’patient with sinusitis and a ‘test’ patient withacute appendicitis. Nineteen general practitioners were confrontedwith it. The extent to which the simulation distorted realityand the implications of such distortions were considered inan attempt to assess the content validity. The conclusion wasthat the simulation gave a realistic impression of the generalpractitioners' diagnostic and therapeutic approach to patientswith vague complaints. The searching procedures in relationto the complaint and the patient's perception of the complaintwere adequately depicted, and the therapeutic procedures approximatedclosely to reality. There was some distortion in the attentionpaid to psychosocial aspects as these were given more attentionin the simulation than they receive in reality.