BS15PFACILITATING NATIONAL CONSISTENCY IN BREAST CANCER DATA COLLECTION

In Australia there is currently no consistent approach to collecting breast cancer specific data. The National Health Data Dictionary (NHDD) recommends a core set of generic data items for clinical cancer registration. However this list does not include the more detailed items required by specific tumour streams. The NBCC has developed a supplementary set of Breast Specific Data Items and definitions to serve as a guide for specialist breast cancer data collection in Australia. A multidisciplinary Working Group comprising clinical and consumer representation, including three breast surgeons, identified 16 breast specific data items for collection. The items are designed to align with items collected through the RACS National Breast Cancer Audit and leading cancer centres. A range of items from patient data (menopausal status), diagnostic data (HER2 status, sentinel lymph node), treatment (surgical margin clearance and involvement), and breast reconstruction are included. The data items are recommended as best practice for breast cancer specific data collection and aim to facilitate national consistency in defining, recording, and monitoring information about patients with breast cancer. This national approach will contribute to improved patient outcomes by informing planning, quality improvement and evaluation strategies for cancer services. The items are currently being piloted in two sites in NSW and will be available nationally in late 2007.     

亮氨酸脑啡肽的电子结构及构效关系研究

对亮氨酸脑啡肽进行了量子化学(INDO)计算,研究其电子结构特征,讨论其活性部位、作用机理及构效关系。同吗啡和R31833进行了活性部位的电子结构与空间结构比较,推断它们的活性药效结构具有共同特点,与阿片受体相互作用时作用方式相同,作用部位有对应关系,因而具有相同的药理性质。     

Electrolyte composition of rat skeletal muscles after hypokinesia

It has been suggested that the electrolyte composition of rat skeletal muscles may change after the exposure to hypokinesia (diminished muscular activity). Thus, the aim of this study was to determine the concentration levels of ions of Na, K, Ca and Mg in muscle tissue and the endogenous media of 135 rats weighing 140-160 g during the readaptation period (RP) of 30 days and after a 96 days exposure to hypokinesia (HK). The animals were divided into two groups. The 1st group (70 rats) was subjected to "pure" HK, that is, without the use of any preventive measures, and the 2nd group (65 rats) was placed under usual conditions and served as control. For the simulation of the hypokinetic effect, the 1st group of rats were kept in small individual cages made of plexiglass. The concentration levels of ions of Na, K, Ca and Mg were determined in muscle tissue and the endogenous media of rats by the method of atom-absorption spectrophotometry. Blood plasma ion composition changed significantly. Tissular fluid content and the tissular concentrations of Na, K, Ca and Mg in muscles also changed significantly during the readaptation period. It was concluded that the concentration levels of ions of Na, K, Ca and Mg in connective tissues, as well as endogenous medium of rats evidently changed significantly during the readaptation period and after the exposure to hypokinesia.     

Creatine excretion in urine of man under hypokinesia and physical exercise

It is known that hypokinesia (diminished muscular activity) induces changes in various biochemical parameters of the organism, including creatine. Thus the aim of this study was to determine daily excretion of creatine under 100-days' exposure to hypokinesia (HK) in essentially healthy men, aged 18-23 years. They were divided into two groups with 3 men in each. The control group of men was subjected to "pure" HK i.e. without the use of any preventive measures, and the experimental group was submitted to combined HK and PE (physical exercise). For the simulation of the hypokinetic effect both groups of men were kept under a rigorous bed rest regime. Creatine excretion was calculated by conventional methods. The results obtained were analyzed statistically. In the control group of men the increased renal excretion of creatine was found in the initial 60-days' period of HK and return to the baseline level during the 60th-90th days. In the experimental group of men a reduced delayed elevation of creatine elimination in urine was manifested only during the 60th-90th days of HK. It was concluded that increased creatine excretion in urine developed during initial HK. Physical exercise may be used to attenuate creatinuria under diminished muscular activity.     

部分脱乙酰甲壳质生物套管小间隙桥接修复周围神经损伤:免疫组织化学观察

目的:神经断端保留小间隙的静脉桥接模拟神经外膜形成神经再生室,为周围神经再生创造了良好的生理环境,从而保证神经束的良好对合。实验采用部分脱乙酰甲壳质作为套管材料,用小间隙桥接方法修复坐骨神经损伤,观察套管内的神经再生情况,并与传统外膜缝合法进行比较。方法:实验于2001-01/2002-10在北京大学人民医院创伤骨科实验室完成。①主要材料:实验所用中空圆柱形套管为北京大学人民医院与中国纺织科学院共同发明的一种部分脱乙酰甲壳质生物套管(专利号:01136314.2)。实验中所用套管尺寸为:管长4 mm,壁厚0.1 mm,内径1.5 mm。②实验动物:健康成年雄性SD大鼠20只,随机分成2大组,每组10只,每一大组全部10只动物的左腿坐骨神经为一组,右腿坐骨神经为另一组,每组10根坐骨神经。另取5只同样大鼠双侧坐骨神经未做处理作为正常对照组。③实验方法:外膜原位缝合组:切断坐骨神经,显微镜下神经外膜原位缝合;生物套管小间隙原位桥接组:切断坐骨神经,显微镜下小间隙套管桥接;断端旋转180°外膜缝合组:切断坐骨神经,显微镜下远端旋转180°后,神经外膜缝合;断端旋转180°生物套管小间隙桥接组:切断坐骨神经,显微镜下远端旋转180°后,小间隙套管桥接。④实验评估:术后第7,14,21,28,42天取坐骨神经,进行免疫组织化学染色及观察。结果:再生神经延套管中央走行,7 d时已有部分纤维通过2 mm间隙,14 d时有髓纤维数量明显多于近端。21 d后,套管组与原位外膜组新生有髓神经纤维数相近。再生纤维胞核数量较多,髓鞘纤细。套管结构完整。结论:此种部分脱乙酰甲壳质生物套管内的再生神经连续、整齐,髓鞘完整,其神经再生情况好于传统外膜缝合法。     

Phosphate homeotasis in healthy subjects during prolonged periodic and continuous hypokinesia

OBJECTIVE: This study aimed to show that during hypokinesia (HK), phosphate (P(i)) imbalance increases more with higher than lower physical activity and that P(i) absorption reduces more with higher than lower P(i) imbalance in subjects with higher than lower muscular activity. METHODS: Studies were conducted on 30 healthy male subjects during 364 days of HK. They were equally divided in three groups: unrestricted active control subjects (UACS), continuously hypokinetic subjects (CHKS) and periodically hypokinetic subjects (PHKS). CHKS were kept under average walking distances of 0.5+/-0.2 km day(-1) PHKS were kept under average walking distances of 0.5+/-0.1 and running average distances of 8.7+/-1.2 km day(-l) for 5 days and 2 days per week, respectively. UACS were placed under average running distances of 8.7+/-1.2 km day(-l). RESULTS: P(i) imbalance, serum, urine and fecal P(i) levels, and urine and serum calcium (Ca(2+)) levels increased significantly (p<0.05) and P(i) absorption, and serum intact parathyroid hormone (iPTH) and 1,25-dehydroxyvitamin D (1,25 (OH)(2) D(3)) levels decreased significantly (p<0.05) in CHKS and PHKS compared with their pre-HK values and their respective active control (UACS). However, the P(i) imbalance, serum, urine and fecal P(i) levels, and serum and urine Ca(2+) levels increased more significantly (p<0.05), and P(i) absorption and serum iPTH and 1,25 (OH)(2) D(3) levels decreased more significantly in PHKS than in CHKS. CONCLUSIONS: Higher P(i) imbalance with higher than lower physical activity shows that the risk of higher P(i) imbalance is inversely related to the intensity of physical activity. Lower P(i) absorption with higher than lower P(i) imbalance shows that the risk of lower P(i) absorption is inversely related to magnitude of P(i) imbalance. In conclusion P(i) imbalance increases more with higher than lower physical activity and that P(i) absorption decreases more with higher than lower P(i) imbalance indicating that during HK the use of P(i) decreases more with higher than lower physical activity.     

Fluid distribution measurement between body compartments in primates in disclosing fluid retention during prolonged hypokinesia

Body fluid homeostasis undergoes significant changes during hypokinesia (diminished movement). Understanding of fluid transfer between body fluid compartments and its regulating mechanisms was the aim of this study for disclosing impaired fluid retention during hypokinesia (HK).Studies were done on 12 male Macaca mulatta (rhesus monkeys) aged three to five years (5.15 to 6.56 kg) during 90 days period of pre-HK and 90 days period of HK. All primates were divided equally into two groups: vivarium control primates (VCP) and hypokinetic primates (HKP). Hypokinetic primates were kept for 90 days in small individual cages that restricted their movements in all directions without hindering food and fluid intakes. Control primates were housed in individual cages without their movements being restricted.Total body fluid (TBF), intracellular fluid volume (IFV) and circulating plasma volume (CPV) decreased significantly (p < 0.05), while extracellular fluid volume (EFV) and interstitial fluid volume (IsFV) decreased significantly (p < 0.05) at the initial seven days of the HK period and after the 7th day increase progressively in HKP compared with their pre-HK values and their respective control values in VCP. Fluid excretion, urinary and plasma sodium (Na) and potassium (K) levels increased significantly (p < 0.05), while fluid intake and fluid retention decreased significantly (p < 0.05) in HKP compared with their pre-HK values and their respective controls in VCP. The measured parameters did not change in VCP compared with their pre-HK values.It was concluded that decreased IFV and CPV may demonstrate fluid depletion, while marked increase of fluid loss despite of fluid depletion may demonstrate impair fluid retention during HK. Dissociation between fluid loss and fluid depletion maydemonstrate the presence of reduced fluid retention as the mechanism ofdevelopment of fluid depletion during HK.     

Phosphate measurements during hypokinesia and phosphate supplements in disclosing phosphate changes in hypokinetic subjects

BACKGROUND: Hypokinesia (diminished movement) induces significant phosphate (P) change, however, little is known about P retention and P depletion during hypokinesia (HK). Measuring P retention and P balance during HK and P supplementation, the objective of this work was to disclose whether HK could contribute to the decreased P retention and consequently to P depletion in normal subjects. METHODS: Studies were done during 30 days pre-HK period and 364 days HK period. Forty normal male individuals aged, 25.3+/-6.4 years were chosen as subjects. They were divided equally into 4 groups: unsupplemented active control subjects (UACS), unsupplemented hypokinetic subjects (UHKS), supplemented active control subjects (SACS) and supplemented hypokinetic subjects (SHKS). Hypokinetic subjects were limited to an average walking distance of 0.5 km day-l, while active control subjects were kept on an average running distance of 9.6 km day-l. Both, SHKS and SACS received daily 14 mmol dicalcium phosphate per kg body weight. RESULTS: Negative P balance, fecal P, urinary calcium (Ca) and P excretion, serum P and total (Cat) level increased significantly (p<0.05) while P retention, serum intact parathyroid hormone (iPTH), 1,25 dihydroxyvitamin D (1,25 (OH)2 D3) and thyrocalcitonin (TC) decreased significantly (p<0.05) in SHKS and UHKS compared with their pre-HK values and their respective active controls (SACS and UACS). However, negative P balance, P retention incapacity, serum, fecal and urinary P level increased significantly (p<0.05) more in SHKS compared with UHKS. Fecal P loss, urinary P and Ca loss, serum P and Cat level, iPTH, TC and 1,25 (OH)2 D3 level, P retention and P balance change insignificantly (p>0.05) in SACS and UACS compared with their pre-HK level. CONCLUSIONS: It was concluded that a significant P excretion in urine and feces in spite of negative P balance and P supplementation may demonstrate reduced P retention, while a significant increase of negative P balance may demonstrate P depletion. Clearly, P intake, regardless of its low or higher dose, was significantly wasted during HK probably due to the decreased ability of the body to retain P.     

Plasma, urinary and fecal potassium changes in athletes during ambulatory, periodic, and continuous hypokinetic conditions

OBJECTIVES: Prolonged hypokinesia (HK) induces significant electrolyte changes, but little is known about the effect of prolonged periodic hypokinesia on plasma, urinary, and fecal K. The aim of this study was to measure potassium (K) changes during prolonged periodic (PHK) and continuous (CHK). DESIGN AND METHODS: Studies were done during the pre HK and HK periods. Thirty male athletes were chosen as subjects. They were divided equally into three groups: unrestricted ambulatory control subjects (UACS), continuously hypokinetic subjects (CHKS), and periodically hypokinetic subjects (PHKS). The CHKS group was kept on a running distance of 0.7 km/day, while the PHKS group kept on a running distance of 0.7 and 11.7 km/day for 5 days and 2 days per week, respectively. The UACS group was on a running distance of 11.7 km/day. RESULTS: The following were measured: fecal K excretion; urinary K; sodium (Na) and chloride (CI) excretion; plasma K; Na and CI concentration; plasma renin activity (PRA) and plasma aldosterone (PA) concentration; physical characteristics; and peak oxygen uptake. Fecal K, urinary K, Na and CI excretion, plasma K, Na and CI concentration, and PRA and PA concentration, increased significantly (p< or =0.01) in the CHKS and PHKS groups when compared with the UACS group. Body weight and VO2 peak decreased significantly (p< or =0.01) in the CHKS group, while body weight increased and VO2 peak decreased significantly (p< or =0.01) in the PHKS group when compared with the UACS group. The measured parameters changed much more in the PHKS group than in the CHKS group. By contrast, the measured parameters did not change significantly in the UACS group when compared with the baseline control values. CONCLUSION: It was shown that prolonged PHK and CHK induce significant plasma and excretory K changes; however, plasma and excretory K changes were much greater in the PHKS group than in the CHKS group. It was concluded that the greater the stability of muscular activity, the smaller the plasma, urinary, and fecal K changes during prolonged HK.