A prospective study of the effect of testosterone escape on preradiotherapy prostate-specific antigen kinetics in prostate cancer patients undergoing neoadjuvant androgen deprivation therapy

Introduction:Prostate-specific antigen (PSA) kinetic patterns during neoadjuvant androgen deprivation therapy have been shown to predict unfavorable long-term outcomes.Objective:To investigate the effect of testosterone escape (TE) on these kinetic patterns, as this had not been previously reported.Methods:There were 50 consecutive prostate cancer patients who received 6 months of triptorelin prior to definitive radiotherapy (RT). Testosterone and PSA levels were measured at baseline and every 6 weeks. Clinical factors were tested for their ability to predict for TE and unfavorable PSA kinetic patterns. The effects of TE, at both 1.7 and 0.7 nmol/L levels, were analyzed.Results:TE occurred in at least one reading for 14% and 34% of the patients at the 1.7 and 0.7 nmol/L levels, respectively. No baseline factors predicted TE. The median PSA halving time was 25 days and the median pre-RT PSA level was 0.55 ng/mL. The only factor significantly associated with a higher pre-RT PSA level was a higher baseline PSA level. The only factor that significantly predicted a longer PSA halving time was TE at the 1.7 nmol/L level.Conclusions:TE and higher baseline PSA levels may adversely affect PSA kinetics and other outcomes for patients undergoing neoadjuvant hormone therapy prior to radiotherapy. Studies investigating the tailoring of neoadjuvant therapy by extending the duration in those patients with a higher baseline PSA level or by the addition of anti-androgens in those demonstrating TE, should be considered.     

Case report of Brunner’s gland hyperplasia: A rare “mimic” of malignant pathology

IntroductionBrunner’s gland hyperplasia is a rare, benign lesion of the duodenum. The symptomology can range from asymptomatic (as an incidental finding on endoscopy) to gastrointestinal obstruction or haemorrhage.Case presentationWe report a case of a 60-year-old man presenting with post-prandial vomiting and weight loss. Inpatient evaluation led to the likely diagnosis of a duodenal malignancy for which the patient underwent a laparotomy and proximal duodenectomy.Clinical discussionBrunner’s gland hyperplasia is a rare, benign condition that can be overtreated due to the difficulty in obtaining an accurate pre-operative diagnosis. The literature has been reviewed to discuss the approach to diagnosis.ConclusionThis case highlights the potential for Brunner’s gland hyperplasia mimicking a malignancy.     

Therapeutic effects of radio frequency ablation in lung tumor treatment

Radiofrequencyablation(RFA)isarecentlyde-velopedsystemthatprovidesanewapproachforthetreatmentofpatientswithunresectablemalignanttu-mor.Aninsulatedneedleelectrodethatcontains10fineneedleswithinentersthetumortissueunderCTguidanceandthe10fineneedlesstretchasanumbrel-lacoveringanareaapproximately3.5cmindiameter,beforearadiofrequencygeneratortransmitshigh-en-ergyradiofrequencypulsesthroughthewiretothefineneedles.Theenergyreleasedattheneedlepointcantriggerionicagitationandfrictionalheattopro-ducea…     

运用原位DNA末端标记法研究细胞凋亡对乳腺癌预后的影响

研究临床乳腺癌标本中细胞凋亡的发生情况,评价其在预测后在的意义。方法搜集９１例浸润性乳腺癌的石蜡组织切片,运用原位ＤＮＡ断裂位点的末端标记法,检测细胞凋亡,计算凋亡细胞占肿瘤细胞的百分比,求得凋亡指数。结果本组病例细胞凋亡发生率为９１．２％,凋亡指数分为两组：０～０．２１和０．２８～０．６２,凋亡指数高低与腋淋巴结转称相关（Ｐ＜０．０１）。生存率单因素分析中,凋亡指数高的病例,无病生存率（Ｐ＝０．００９５）及总生存率（Ｐ＝０．０３４８）均优于凋亡指数低的病例。但Ｃｏｘ模型多因素分析末能指示凋亡指数是一个独立的预后指标。结论在乳腺癌组织中,细胞凋亡是一种自发现象,其发生情况各有不同,研究初步提示了细胞凋亡在乳腺癌预后中的作用,了解了凋亡和腋淋巴结转移的相关性。     

鼻咽癌中与已知基因同源的差异表达cDNA序列

采用新近发展的ｃＤＮＡ代表性差异分析法筛选鼻咽癌中不表达的或表达降低的ｃＤＮＡ序列。结果显示：有９个与已知基因高度同源的ｃＤＮＡ序列。通过对这些已知基因的结构和功能分析,发现有与细胞骨架成分相关的基因：αａｃｔｉｎｉｎ,ｅｚｒｉｎ和细胞角蛋白１３;直接与瘤基因和抑瘤基因相互作用的基因：鲨烯合成酶和ＴＲＩＰ１基因;直接参与ＤＮＡ合成以及调控基因转录和翻译的基因：ＴＡＦⅡ６８和组蛋白Ｈ１０;另外还有人类补体因子Ｂ及类转运ＲＮＡ合成酶的基因。这些基因大多具有相当于抑瘤基因的功能。从而进一步说明鼻咽癌的发生是多基因相互作用的结果。     

Allergic skin reactions to anticonvulsant medications in patients receiving cranial radiation therapy

PURPOSE: Erythema multiforme and Stevens-Johnson syndrome have been associated with anticonvulsant medications (AEDs) in patients with brain tumors receiving cranial irradiation. AEDs are also known to cause mild drug rashes. The incidence of these complications has not been well studied among patients with brain tumors. We reviewed the records of patients with brain tumors treated with cranial radiation and AEDs to assess the frequency of both severe and mild skin reactions. METHODS: Retrospective review of 289 radiotherapy records of consecutively treated patients from 1988 to 1993. RESULTS: Only one of 289 patients developed erythema multiforme. Milder rashes, however, occurred in 18% of exposures to AEDs including 22% of exposures to phenytoin, compared with the expected rate of 5-10%. Most of the mild drug rashes occurred before the initiation of radiotherapy, suggesting that radiation was not the cause of these reactions. CONCLUSIONS: Severe skin rashes are rare among patients with brain tumors receiving radiation therapy and AEDs. There is, however, an increased frequency of mild drug rashes among patients with brain tumors that does not appear related to radiation.     

先天性胆总管囊肿并发肝功能异常的临床意义

目的 探讨先天性胆总管囊肿肝功能异常的病理基础及临床意义,方法 分析８０例先天性胆总管囊肿患者的肝功能结果,对其中的３６例进行肝病理观察及随访,结果 该病患儿肝功能异常的发生率为８０％,胆汗淤滞是其病理基础,手术后随胆汁淤滞的解除,肝功能均恢复正常,结论 及时手术解除明道梗阻是改善肝功能的根本途径。     

The vascular ‘sunburst’ appearance of osteosarcoma: A new angiographic finding

The angiographic analogue of the sunburst, (right angle) periosteal new bone formation in osteogenic sarcoma is described. The angiographic findings in this tumor and their relationship to the pathologic appearance are discussed.     

Benzamide action at α2-adrenoceptors modifies catecholamine-induced contraction and relaxation of circular smooth muscle from guinea-pig stomach

Summary Dopamine was shown to act on the circular smooth muscle of the stomach body to cause contraction at a yohimbine-sensitive site (₂) and a relaxation at a prazosin-sensitive site (₁). Metoclopramide and tiapride failed to modify either response, failed to antagonise a relaxation to phenylephrine at 1(₁ sites in the same tissue, and failed to modify the contractions caused by dopamine and phenylephrine at an ₂-adrenoceptor site in the pyloric sphincter. However, (+)- and (–)-sultopride and (+)-sulpiride antagonised the dopamine-induced contractions of the stomach body indicating an ₂-antagonist action. An ability to attenuate the relaxation of this tissue may reflect a displacement of the contraction curve to the right rather than an ₂-antagonist action since the response to phenylephrine was not antagonised either in this tissue or in the pyloric sphincter. Within the central nervous system the (–)-enantiomers of sultopride and sulpiride have a highly selective dopamine receptor blocking action. This cotrasts with the present findings in the stomach musculature of a non-stereospecific antagonism at ₂-type adrenoceptors.