Quality of life in adult survivors of lung,colon and prostate cancer

In a cross-sectional study design, a disease free sample of 57 lung, 117 colon, and 104 prostate cancer survivors who represented short, intermediate and long-term survivors completed a detailed assessment of quality of life (QOL) and rehabilitation needs using the CAncer Rehabilitation Evaluation System (CARES). Demographic and medical data, social support, and a global QOL rating were also assessed. Lung cancer patients showed no differences in QOL with respect to their period of survival. QOL improved for survivors of colon cancer as they lived for longer periods, but declined with time for survivors of prostate cancer. The best predictor of QOL for all groups was KPS, although other variables such as type of hospital, gender, and work status were predictive for survivors of colon cancer. For survivors of prostate cancer comorbidity with other medical illnesses, time since diagnosis and comorbidity due to psychiatric difficulties were predictive of QOL. All groups had significant rehabilitation problems in the domains of physical, psychosocial, sexual, medical interaction, and marital relationships. Lung cancer survivors had more problems than the other cancer survivors. We conclude that patients who survive cancer do not return to a state of normal health. They demonstrate a variety of difficulties with which they must cope as they continue to survive. Greater efforts need to be made early in diagnosis and treatment to understand rehabilitation problems and target interventions in the hope of reducing later sequelae.Currently in private practice, Glendale, CaliforniaC. A. C. Schag was supported in part by Veterans Administration Health Research and Development Grant 83-002 and in part by Cares Consultants, 2210 Wilshire Blvd., Suite 359, Santa Monica, CA 90403.Address requests for Information about CARES to: CARES Consultants, 2210 Wilshire Blvd., Suite 359, Santa Monica, CA 90403, USA. Tel: (+1) 310-450-7410; Fax: (+1) 310-399-0016     

C1: molecular interactions with activating systems.

The molecular events controlling complement activation have been gradually unravelled over the past three decades, stimulated by improved isolation procedures and a better understanding of the roles of individual proteins. In this review, Bob Sim and Ken Reid examine the interactions between C1q and its numerous ligands in the initiation of the classical pathway cascade.     

Access to primary health care for Australian young people: service provider perspectives.

BACKGROUND: To adequately address the complex health needs of young people, their access to services, and the quality of services received, must be improved. AIMS: To explore the barriers to service provision for young people and to identify the training needs of primary healthcare service providers in New South Wales (NSW), Australia. DESIGN OF STUDY: A cross-sectional, qualitative study of the perspectives of a range of health service providers. SETTING: A range of primary healthcare organisations across NSW. METHODS: Samples of general practitioners (GPs), youth health workers, youth health coordinators, and community health centre staff were drawn from urban and rural clusters across NSW. Focus groups and interviews were used to identify barriers to service provision and the training needs of service providers. Data were tape recorded, transcribed, and analysed. RESULTS: Barriers to service provision among GPs and community health centre staff included inadequate time, flexibility, skills, and confidence in working with young people, and poor linkages with other relevant services. Training needs included better knowledge of and skills in adolescent health requirements, working with adolescents, and working with other services. Barriers to service provision for youth health workers and coordinators included lack of financial resources and infrastructure. There were few linkages between groups of service providers. CONCLUSION: Models of service provision that allow stronger linkages between service providers, sufficient time for consultation with young people, adequate training and support of health professionals, and flexibility of service provision, including outreach, should be explored and evaluated.     

THE HISTOLOGIC FEATURES AND HISTOGENESIS OF MALIGNANT OVARIAN BRENNER TUMOR

Eight cases of malignant and 12 0f benign Bren- ner tumor are reported, patient ages ranged 31 69 and 39-53 years. The malignant tumor was bilateral in 6 0f 8 cases, and the benign in l of 12. The greatest diameter of the malignant tumors averaged around 11 cm, and the benign 10. Six of the malignant Brenner tumor patients died, one was lost to follow up, and one survived for 10 years. Pathologic and microscopic findings were pre- sented in some detail. Based on the analysis of the association between the histologic features and type of Mullerian epithelium, we believe that the so called Brenner tumor is in effect a tumor arising from the Mullerian epithelium with a tendency to differentiate into vaginocervical type epithelium.     

Psoas abscess due to retroperitoneal tuberculous lymphadenopathy

A case of psoas abscess occurring during treatment of tuberculous lymphadenopathy is described. There was no evidence of a bony origin for this abscess. It appears likely that it arose from involved glands on the posterior abdominal wall.     

介入手术治疗异位妊娠12例临床分析

目的：探索一种治疗输卵管妊娠的微创介入手术，解决因其腹腔出血不能接受保守治疗或保守治疗失败的难题。保持输卵管完整及通畅，满足有生育需求的患。方法：对12例输卵管妊娠妇女行对侧股动脉穿刺，将导管超选择插至子宫动脉以甲氨喋呤(MTX)进行灌注及明胶海绵栓塞术。结果：本组病例中，术后10dB超复查孕囊脱落、吸收消失，栓塞后盆腔活动性出血停止。结论：介入治疗宫外孕输卵管妊娠，能有效杀灭胚胎组织，栓塞破裂血管止血效果明显，且能保持输卵管通畅。     

Benign osteoblastoma of the occipital bone: Case report and literature review

We present a case of benign osteoblastoma of the occipital bone. Benign osteoblastoma is an uncommon primary bone tumor, which usually involves the vertebrae and the long bones. This tumor rarely develops in the calvaria, showing a preference for the temporal and frontal bones when it does. To the best of our knowledge, this case is only the eighth reported case of benign osteoblastoma confined to the occipital bone. A 20‐year‐old male presented with a mild tender mass lesion of the occipital area, just below the lambda. Plain X‐ray films and CT scans demonstrated an osteolytic mass surrounded by the sclerotic rim within the diploic space. MRI proved to be effective for the evaluation of the intracranial and intraosseous extensions of the tumor. However, it was very difficult to formulate a differential diagnosis against other osteoblastic tumors, or osteoid osteoma, in view of its radiological appearance. The final diagnosis was obtained by careful consideration of the histopathological characteristics of the tumor combined with its clinical and radiological features. Although generally regarded as benign, a complete resection is preferred over conventional curettage as this can guard against possible recurrence and malignant transformation.