Echogenicity of prostate cancer correlated with histologic grade and stromal fibrosis: endorectal US studies

In this study an attempt was made to clarify some of the causes of the apparent differences in appearance on ultrasound (US) images of prostate cancer. These differences were correlated with histologic grade and the degree of stromal fibrosis present. Fifty-one cancers (diagnosed and evaluated by means of US-guided biopsy or evaluated by means of radical prostatectomy) were studied. There were 30 hypoechoic, ten echogenically mixed, six isoechoic, and five subtly hyperechoic cancers. The degree of stromal fibrosis was minimal in well-differentiated cancers and increased in poorly differentiated cancers. In addition, the more hypoechoic lesions were, in general, the better-differentiated cancers and had less fibrosis. There was a tendency for the isoechoic cancers and those with subtly hyperechoic areas to more often have poor cellular differentiation and a greater degree of stromal fibrosis, but considerable overlap among histologic types was seen.     

Impact of season and discharge weight on complications and growth of Kangaroo Mother Care treated low birthweight infants in Mozambique

This study aimed to determine the impact of season and weight at discharge on growth rate and complications in low birthweight infants treated with Kangaroo Mother Care (KMC) in Maputo, Mozambique. The study population included 246 infants of birthweight < 2000 g. Follow-up until 2400 g was obtained in 64%. There were no seasonal differences in weight gain and the risk of complications of infants treated with KMC in hospital. During the cold season after discharge, the risk of serious complications, including death, was higher (risk ratio 1.96; p = 0:02) and more readmissions occurred (risk ratio 2.77; p = 0:04). We postulate that after discharge mothers are unable to comply with the kangaroo position at all hours of the day and that exposure to low ambient temperatures may explain the more frequent occurrence of complications in the cold season. The weight at discharge did not affect complications or growth rate. We conclude that the current policy to discharge infants when having gained weight on 3 consecutive days, regardless of the actual weight, or whether the weight at birth has been regained, is adequate. In the cold season particularly, more efforts may be needed to ensure compliance with kangaroo position after discharge and to educate mothers on early signs of complications such as bronchopneumonia to encourage timely care seeking. With this method, low birthweight infants can grow adequately.     

Daily Assessment of Stressful events and Coping in early post‐operative recovery after colorectal cancer surgery

This study describes the most stressful events and coping strategies used by patients with colorectal cancer 4–6 weeks after surgery and whether the coping strategies were considered helpful or not. For the investigation of situational coping, an exploratory design was used. One hundred and five patients from three Swedish hospitals were included to fill in the Daily Coping Assessment. Most stressful event, number and types of pre‐defined coping strategies used, and if the coping strategy used was considered helpful or not, were measured for 5 days. Of 523 diary entries, 180 reported no stressful events. The most stressful event, also with worst level of control and expectation, was “Pain,” followed by “Nausea/vomiting.” The areas causing most stressful events were “Bowel‐related” and “Surgery and treatment‐related problems.” Acceptance and Direct action were the most frequently used coping strategies. There was a wide range of perceived helpfulness if coping strategies were placed in relation to specific areas of events. The conclusion was that patients revealed several strategies for coping with stressful events but needed a higher level of preparedness for what might come and therefore need to be given appropriate support to cope during the early recovery phase. Such support is suggested to be person‐centred and oriented towards individually adapting standardised regimens, given the variety of situations to which the stressful events reported in the study were related.     

湖北贝母属植物化学成分的研究——Ⅹ.紫花鄂北贝母生物碱的分离与鉴定

紫花鄂北贝母FritiItaria ebeiensis var.pvrpvreaG.D.Yu et P.Li系贝母属植物新变种,从它的鳞茎中分离到Ⅰ～Ⅶ个生物碱。经理化常数测定和波谱分析,并与标准品对照,鉴定碱Ⅰ,Ⅱ,Ⅲ和Ⅳ分别为浙贝甲素(peimine)、浙贝乙素(peiminine)、鄂贝甲素(ebeinine)和鄂贝乙素(ebeinone)。碱Ⅵ为新的异甾生物碱,定名为紫鄂贝碱(ziebeimine),其结构鉴定为5α,14α-cevanine-13,17-dehydro-3α,6β-diol。碱Ⅴ和Ⅶ的结构尚待鉴定。     

Evaluation by angiography of the lateral dominance of the drainage of the dural venous sinuses

Summary Venous drainage dominance of the dural venous sinuses may be defined as the drainage only or mainly into one of the transverse sinuses, as shown by bilateral carotid angiography. The aim of this study was to evaluate the venous drainage dominance in bilateral carotid angiograms of 189 cases retrospectively. Among these cases 41.3% showed drainage mainly to the right side, 37.6% showed equal drainage to each side, 18.5% showed drainage mainly to the left side, 2.1% showed drainage only to the right side and 0.53% showed drainage only to the left side. Cerebral venous drainage dominance is of great importance and should be considered before operations on patients for radical neck dissection, removal of tumors in the neck that invade the internal jugular vein or tumors of the glomus jugulare which may require ligation of the internal jugular vein.

---

Evaluation angiographique de la prédominance du drainage veineux des sinus dure-mériens

Résumé La prédominance angiographique du drainage des sinus veineux dure-mériens se traduit par le drainage de la substance radioopaque essentiellement ou uniquement par l'un des sinus transverses au cours d'angiographies carotidiennes bilatérales. Le but de ce travail est d'évaluer la prédominance du drainage veineux sur 189 angiographies carotidiennes bilatérales. Dans 41,3% des cas, on note une prédominance à droite. Dans 37,6% des cas, le drainage veineux s'effectue de façon égale des deux côtés. Dans 18,5% des cas, il y a prédominance à gauche. Dans 2,1% des cas le drainage est limité à droite et dans 0,53% des cas il est limité à gauche. La connaissance de cette prédominance du drainage veineux cérébral est capitale pour le chirurgien lors de curage cervical radical, lors d'intervention pour des tumeurs du cou envahissant la veine jugulaire interne ou pour des tumeurs du glomus jugulaire nécessitant la ligature de la veine jugulaire interne.

     

Acceleration of full-thickness wound healing in normal rats by the synthetic thrombin peptide, TP508

Thrombin is an essential factor in hemostasis, inflammation, and tissue repair. The synthetic thrombin peptide, TP508, binds to high-affinity thrombin receptors and mimics cellular effects of thrombin at sites of tissue injury. Treatment of full-thickness excisional wounds in normal rats with a single topical application of 0.1 microg TP508 (14 pmol/cm2) reproducibly accelerates wound closure, yielding wounds that on average close 39% more than controls by day 7 (p < 0.001). Wounds treated with 1.0 microg TP508 are 35% and 43% (p < 0.001) smaller than controls on day 7 and 10, respectively. The early rate of closure is approximately 40% greater in TP508-treated than vehicle-treated wounds (20 versus 14 mm2/day) and remains higher through day 7. Breaking strength after closure is slightly greater (15-23%) in wounds treated with TP508 than with saline alone. Histologic comparisons show that TP508 enhances recruitment of inflammatory cells to the wound site within 24 hours post-injury. TP508 treatment also augments revascularization of injured tissue, as evidenced at day 7 by the larger size of functional vessels in the granulation tissue and by the directed development of blood vessels to wounds. These studies raise the possibility that TP508 may be clinically useful in management of open wounds.