A Survey of Alcohol Consumption Among First-Year Military Medical Students

First-year medical students (n = 138) at the U.S. Military's Medical School report frequent binge drinking. Nearly one fifth of female and one third of male students report at least one episode of binge drinking in the two weeks preceding a survey of alcohol use. Only one fifth of the medical students reported an interest in an expanded addiction medicine curriculum. The authors' promoted the use of a survey to bridge the gap between self assessment and learning.     

A combination of orgasmic reconditioning and covert sensitization in the treatment of a fire fetish

A 20-year-old male reported a history of fire-setting behavior associated with masturbation as his sole means of obtaining sexual gratification. Physiological and subjective measures indicated sexual arousal to photographic slides of fire and lesser arousal to slides of nude females. Treatment included a new version of orgasmic reconditioning to increase heterosexual arousal and covert sensitization to decrease deviant arousal. At the end of treatment, sexual arousal was greater for heterosexual than for fire stimuli. Masturbatory fantasies were reported to be exclusively heterosexual and no further fire-setting incidents were reported. These changes were maintained at both 4 and 9 month follow-ups.     

Missing band 7 membrane protein in two patients with high Na, low K erythrocytes.

We investigated the erythrocyte membrane proteins of two patients with congenital hemolytic anemia due to increased permeability of the erythrocyte membrane to Na and K (hereditary stomatocytosis and cryohydrocytosis). One-dimensional sodium dodecyl sulfate (SDS) gel electrophoresis resolved the band 7 erythrocyte membrane proteins into three components with approximate molecular weights of 30,000, 28,000, and 26,000. The 28,000-dalton component was decreased in both patients with permeability disorders. Two-dimensional electrophoresis (nonequilibrium pH gradient electrophoresis in the first dimension combined with SDS gel electrophoresis in the first dimension combined with SDS gel electrophoresis in the second dimension) resolved the 28,000-dalton component from normal erythrocyte membranes into two proteins with different isoelectric points, designated 22 x 8 and 60 x 8. In the patients with hereditary stomatocytosis and cryohydrocytosis, 22 x 8 was completely absent, whereas 60 x 8 was detected as usual. In contrast, all the band 7 proteins (including 22 x 8) were invariably present in a survey of normal subjects and reticulocytosis controls. The unique finding of a missing band 7 protein in the patients with hereditary stomatocytosis and cryohydrocytosis raises the possibility that the absence of this protein is responsible for the increased Na and K permeability in these disorders.     

Fractionation of bulldog ant venom

The venom of an Australian Bulldog Ant, Myrmecia pyriformis, has been fractionated by means of low voltage starch gel electrophoresis and gel filtration on Sephadex G50 and G75 columns. The aims of the study were (a) to establish whether the biological activities which had previously been described resided in separate venom components, and (b) to isolate, in a purified form, the component possessing non-histamine smooth muscle stimulant activity. Starch gel electrophoresis demonstrated the presence of seven protein components. Sephadex gel filtration resulted in the separation of a fraction which appeared homogeneous on starch gel electrophoresis. This fraction, which was enzyme-free, possessed smooth muscle stimulant, red cell lysing and histamine-releasing activities and resembled the major peptide from bee venom, melittin.     

Pancreatic pseudocysts presenting as thick-walled renal and perinephric cysts.

Posterior extension of a pancreatic pseudocyst should be considered in the differential diagnosis of a thick-walled renal or perinephric cyst seen on infusion pyelography with tomography. Opacification of the wall of a pancreatic pseudocyst by this technique has not been reported previously and lack of knowledge of this possibility can lead to mistaken diagnosis and the possibility of an unnecessary exploratory operation, particularly when angiography is inconclusive and a gastrointestinal series is negative or equivocal. The mechanism of opacification of the wall of a pancreatic pseudocyst is discussed. Parasitization of the renal capsular arteries by a pancreatic pseudocyst can further compound the difficulty of diagnosis.     

A phase III randomized trial comparing adjuvant concomitant chemoradiotherapy versus standard adjuvant chemotherapy followed by radiotherapy in operable node-positive breast cancer: final results

PURPOSE: To compare concomitant and sequential adjuvant chemoradiotherapy regimens in node-positive, operable breast cancer patients. METHODS AND MATERIALS: This was a randomized, French, multicenter, phase III trial enrolling 638 eligible women with prior breast surgery and positive axillary dissection. Patients in Arm A received 500 mg/m2 5-fluorouracil, 12 mg/m2 mitoxantrone, and 500 mg/m2 cyclophosphamide, with concomitant radiotherapy (50 Gy +/- 10-20-Gy boost). Patients in Arm B received 500 mg/m2 5-fluorouracil, 60 mg/m2 epirubicin, and 500 mg/m2 cyclophosphamide, with subsequent radiotherapy. Chemotherapy was administered on Day 1 every 21 days for 4 cycles. RESULTS: Median treatment durations were 64 and 126 days (Arms A and B, respectively), with no significant difference in overall or disease-free survival. Five-year locoregional relapse-free survival favored patients with conservative surgery (two thirds of the population), with less local and/or regional recurrence in Arm A than in Arm B (3% vs. 9%; p = 0.01). Multivariate analysis in this subgroup showed a 2.8-fold increased risk of locoregional recurrence with sequential chemoradiotherapy, independent of other prognostic factors (p = 0.027). Febrile neutropenia and Grade 3-4 leukopenia were significantly more frequent in Arm A. Subclinical left ventricular ejection fraction events at 1 year were more frequent with concomitant radiotherapy (p = 0.02). CONCLUSIONS: Concomitant radiotherapy with adjuvant fluorouracil, mitoxantrone, and cyclophosphamide has significantly better locoregional control in node-positive breast cancer after conservative surgery and 50% shorter treatment, albeit with slightly more acute toxicity. With mitoxantrone no longer available for adjuvant breast cancer treatment, alternative concomitant chemoradiotherapy studies are needed.