The prevalence,severity, and correlates of psychological distress and impaired health-related quality of life following treatment for testicular cancer: a survivorship study

Purpose

This study aimed to establish the prevalence, severity, and correlates of psychological distress and impaired generic health-related quality of life (HRQOL) in testicular cancer (TC) survivors.

Methods

Men who had completed active anti-cancer treatment for TC between 6 months and 5 years previously showing no evidence of recurrence were recruited from 14 Australian cancer centers from September 2009 to February 2011. Participants completed a self-report questionnaire measuring demographic, disease, and treatment information, psychological distress (i.e., depression, anxiety, and stress; DASS21), generic health-related quality of life (HRQOL; SF-36v2), TC-specific HRQOL (EORTC QLQ-TC26), coping (MAC), social support (DUFSS), and unmet needs (CaSUN).

Results

Of 486 eligible TC survivors, 244 (50.2 %) completed the questionnaire. Compared with normative data, TC survivors reported: small but statistically significant increases in mean levels of anxiety and depression; a greater prevalence of moderate to extremely severe anxiety (19 %) and depression (20 %); and significant deficits to mostly mental aspects of generic HRQOL. The most problematic TC-specific HRQOL issues (e.g., fear of recurrence) were also more mental than physical. In multiple regression analyses, the strongest correlates of psychological distress and impaired generic HRQOL were psychosocial (e.g., helpless/hopeless coping and lower social support) rather than disease or treatment factors.

Conclusions

Generally, TC survivors appear to experience mild psychological distress and HRQOL impairments, while a vulnerable subgroup experience more severe morbidity.

Implications for Cancer Survivors

There is a need to identify TC survivors at risk of poorer outcomes and for interventions to target the areas of greatest impairment (i.e., psychological distress and mental HRQOL).

     

Muscle necrosis in the extremities: evaluation with Tc-99m pyrophosphate scanning--a retrospective review

A retrospective review was done of 34 extremities studied between 1981 and 1985 with technetium-99m pyrophosphate scanning; 22 were subsequently amputated. Results of detailed pathologic examination or immediate postoperative examination of the resected extremity were available in 16 cases. In these cases, scanning had allowed correct prediction of the level of amputation and of the specific areas of muscle infarction in 13 cases. In the one case in which amputation was performed for infection rather than muscle necrosis, the lack of necrosis was correctly predicted with the scan. The limited results of this study indicate that the Tc-99m pyrophosphate scan allows the location of necrotic muscle to be predicted accurately and may therefore be a useful adjunct in determining the best level for ultimate amputation. Special caution is required in those cases in which muscle necrosis is due to acute causes (e.g., traumatic thrombosis) rather than chronic vascular disease.     

The effects of antioxidant supplementation during Percoll preparation on human sperm DNA integrity

The integrity of sperm DNA is crucial for the maintenance of genetic health. A major source of damage is reactive oxygen species (ROS) generation; therefore, antioxidants may afford protection to sperm DNA. The objectives of the study were, first, to measure the effects of antioxidant supplementation in vitro on endogenous DNA damage in spermatozoa using the single cell gel electrophoresis (comet) assay and, second, to assess the effect of antioxidant supplementation given prior to X-ray irradiation on induced DNA damage. Spermatozoa from 150 patients were prepared by Percoll centrifugation in the presence of ascorbic acid (300, 600 microM), alpha tocopherol (30, 60 microM), urate (200, 400 microM), or acetyl cysteine (5, 10 microM). DNA damage was induced by 30 Gy X-irradiation. DNA strand breakage was measured using the comet assay. Sperm DNA was protected from DNA damage by ascorbic acid (600 microM), alpha tocopherol (30 and 60 microM) and urate (400 microM). These antioxidants provided protection from subsequent DNA damage by X-ray irradiation. In contrast, acetyl cysteine or ascorbate and alpha tocopherol together induced further DNA damage. Supplementation in vitro with the antioxidants ascorbate, urate and alpha tocopherol separately has beneficial effects for sperm DNA integrity.      

Minimal invasive Therapiealternativen für das lokalisierte Prostatakarzinom

über die Behandlung des klinisch lokalisierten Prostatakarzinom wird nach wie vor viel diskutiert. Die Behandlungsm?glichkeiten erstrecken sich von den agressiven kurativen Therapien bis zur engmaschigen Kontrolle ohne in die Krankheit einzugreifen (“Watchfull Waiting”). Normalerweise wird jungen Patienten mit einer Lebenserwartung von mehr als 10 Jahren die radikale Prostatektomie (RPE) [7, 8, 19] oder die Bestrahlung vorgeschlagen. Bei ?lteren M?nnern, insbesondere bei solchen mit einer “low grade”-/“low Stage”-Erkrankung, f?llt die Entscheidung aufgrund der h?heren Komorbidit?t schwerer. Da aufgrund dieser Komorbidit?t die Durchführung der aggressiven Therapien deutlich erschwert ist, gelangen die minimal invasiven Therapien, die, sei es durch interstitielle Bestrahlung, Kryo- oder thermale Destruktion zur lokalen Zerst?rung führen, zu neuer Bedeutung [3, 4, 5, 12].     

Glioblastom der Orbita

Zusammenfassung Beschreibung eines Falles von primärem Glioblastom der Orbita bei einem 5 1/2jährigen Knaben; es handelt sich erst um den vierten sichergestellten Fall von Gliom der Augenhöhle. Nach zweimaligem Rezidiv Exenteratio orbitae; vermutlich Dauerheilung. Erstmalig wird eine gliöse Geschwulst der Orbita an Hand der histogenetischen Leiter klassifiziert und in die Gruppe desGlioblastoma multiforme eingereiht; die Rezidivtumoren zeigen zunehmende Entdifferenzierung. Als Ursache der Geschwulstbildung wird in Übereinstimmung mit anderen Autoren eine embryonale Gewebsausschaltung angenommen.     

Synthesis of highly mu and delta opioid receptor selective peptides containing a photoaffinity group

A series of cyclic, conformationally constrained photolabile peptides related to the enkephalins and to somatostatin were designed and synthesized in an effort to develop highly selective and potent peptides for the delta and mu opioid receptors. The following new peptides were prepared and tested for their delta opioid receptor potency and selectivity in the guinea pig ileum assay, the mouse vas deferens assay, and the rat brain binding assay: H-Tyr-D-Pen-Gly-p-NH2Phe-D-Pen-OH (1, [p-NH2Phe4]DPDPE) and H-Tyr-D-Pen-Gly-p-N3Phe-D-Pen-OH (2, [p-N3Phe4]-DPDPE). The following new peptides were prepared and tested for their mu opioid receptor potency and selectivity in the same assays: H-D-Phe-Cys-p-NH2Phe-D-Trp-Lys-Thr-Pen-Thr-NH2 (3, [p-NH2Phe3]CTP) and D-Phe-Cys-p-N3Phe-D-Trp-Lys-Thr-Pen-Thr-NH2 (4, [p-N3Phe3]CTP). The delta selective photoaffinity peptide 2 displayed both high affinity (IC50 = 9.5 nM) and good selectivity (IC50 mu/IC50 delta = 1053) as an agonist at delta opioid receptors in bioassays, and 2 also displayed moderate affinity (33 nM) and excellent selectivity (IC50 mu/IC50 delta = 110) for rat brain delta opioid receptors. The mu selective photoaffinity peptide 4 displayed very weak affinity (8% contraction at 300 nM) at mu opioid receptors in bioassays, but good affinity (IC50 = 48.6 nM) and excellent selectivity (IC50 delta/IC50 mu = 412) for the rat brain mu opioid receptors. These conformationally constrained cyclic photoaffinity peptides may be useful tools to investigate the pharmacology of delta and mu opioid receptors.     

Synthesis and biological evaluation on hMC3, hMC4 and hMC5 receptors of γ‐MSH analogs substituted with l‐alanine

Abstract: To elucidate the molecular basis of the interaction of the native dodecapeptide γ‐MSH with the melanocortin receptors, we performed a structure?activity study in which we systematically replaced l ‐Ala in each position of this peptide. Here we report the binding affinity and agonist potency on human MC3R, MC4R and MC5R. Intracellular cAMP concentration was measured on CHO cells, and binding assays were carried out using membranes prepared from these cell lines which stably express hMC3R, hMC4R and hMC5R. Our results indicate that the last four amino acids in the C‐terminal region of γ‐MSH are not important determinants of biological activity and selectivity at human melanocortin receptors. Interesting results were obtained when l ‐Ala was substituted for His⁶, Phe⁷, Arg⁸ and Trp⁹. For these peptides, the affinity and activity at all three human receptors (MC3R, MC4R and MC5R) decreased significantly, demonstrating that the His‐Phe‐Arg‐Trp sequence in γ‐MSH is important for activity at these three melanocortin receptors. Similar results were obtained when Met³ was replaced with l ‐Ala, suggesting the importance of this position in the interaction with all three receptors. This study highlights the role played by the His‐Phe‐Arg‐Trp sequence in receptor binding and in agonist activity of γ‐MSH.     

Crystal structure of biphalin sulfate: a multireceptor opioid peptide

Abstract: Biphalin is a dimeric opioid peptide, composed of two tetrapeptides connected ‘tail‐to‐tail’, that exhibits a high affinity for all three opioid receptor types (i.e. µ, δ and κ). This study presents the X‐ray crystal structure of biphalin sulfate and compares it to other opioids that interact with the same biological targets. Both halves of the molecule have a folded backbone conformation but differ significantly from one another. Residues 1–4 in biphalin, which compare well with the δ selective opioid peptide DADLE, fold into a random coil. Residues 5–8, which can be fit to the µ selective peptide d ‐TIPP‐NH₂, exhibit a fairly normal type III′β bend. Biphalin also exhibits structural similarities with two naltrexone analogs, naltrexonazine and norbinaltorphamine, that are specific to µ and κ receptor sites.     

Intrauterine spermatic cord torsion in the newborn: sonographic and pathologic correlation

In five newborn patients with spermatic cord torsion, sonography demonstrated an enlarged and globular testis, hydrocele, and skin thickening. In four of these patients the testicular parenchyma was heterogeneous. Peripheral hypoechoic areas were seen in two of the four patients; the other two had a central hypoechoic region and a peripheral echogenic rim. The testis in the fifth patient was diffusely hyperechoic. Duplex Doppler sonography performed in two patients failed to demonstrate any signal in the spermatic cord in either the abnormal or contralateral hemiscrotum. Scintigraphic findings were positive for testicular torsion in two patients and equivocal in three patients. Surgery was performed 2-12 days after sonography and established the diagnosis of spermatic cord torsion. Pathologic examination demonstrated hemorrhagic infarction of the entire testis as well as scattered calcifications. The authors conclude that a solid globular testicular mass seen during the neonatal period is suggestive of intrauterine spermatic cord torsion.     

Vaccinia virus vectors: new strategies for producing recombinant vaccines.

The development and continued refinement of techniques for the efficient insertion and expression of heterologous DNA sequences from within the genomic context of infectious vaccinia virus recombinants are among the most promising current approaches towards effective immunoprophylaxis against a variety of protozoan, viral, and bacterial human pathogens. Because of its medical relevance, this area is the subject of intense research interest and has evolved rapidly during the past several years. This review (i) provides an updated overview of the technology that exists for assembling recombinant vaccinia virus strains, (ii) discusses the advantages and disadvantages of these approaches, (iii) outlines the areas of outgoing research directed towards overcoming the limitations of current techniques, and (iv) provides some insight (i.e., speculation) about probable future refinements in the use of vaccinia virus as a vector.