Management of the complications of external beam radiotherapy and brachytherapy

External beam radiation therapy (EBRT) and brachytherapy are common treatment modalities for newly diagnosed prostate cancer. What complications can patients and physicians expect following these therapies? How are these conditions diagnosed and treated? In this article, we examine several of the most common acute and delayed complications of radiation therapy for prostate cancer. In addition, we discuss appropriate follow-up diagnostics for these patients and our suggestions for management of the main complications that may develop.     

Subject case marking and verb morphology in normally developing and specifically language-impaired children

Recent theories of language development propose a direct relationship between children's use of verb morphology and their use of subject case pronouns. Such proposals might contribute to an understanding of specifically language-impaired (SLI) children's difficulties. These children's extraordinary problems with verb morphology are well documented, and preliminary evidence indicates frequent pronoun case errors (e.g., her for she) in their speech. Thus, it is possible that a collection of difficulties may be linked to a common source in these children. The objectives of this study were to determine: (a) whether subject case marking, as well as verb morphology was more limited in the speech of a group of SLI children than in the speech of a younger group of normally developing (ND) children matched for mean utterance length; (b) whether a relationship between the use of subject case marking and the use of verb morphology existed in the speech of the ND children; and, if so, (c) whether this relationship is evident in the SLI children as well, in spite of their more limited use of these features. The results revealed that the SLI children were more limited than the ND children in the use of both subject case marking and verb morphology. However, a relationship between the two types of usage was found in both groups of children.     

乳酸脱氢酶实验检测细胞新陈代谢的实验研究

目的 探索LDH实验检测细胞活力的可行性。方法 原代培养骨髓细胞和软骨细胞，用LDH实验测定上述两组细胞的活力，并与镜下活体观察到细胞的生长状况相比较。与目前比较成熟的测定细胞活力的MTS实验的测得的值相比较。结果 LDH实验对上述两组细胞的活力的测定结果与镜下活体观察到的结果相符合。与MTS实验的测得的结果经统计学处理无显著差异。结论 LDH实验可用于细胞活力的直接测定，而对活细胞的生存、繁殖无影响。     

New approach to management of intraaortic balloon pumps in patients with peripheral vascular disease: Case reports of four patients requiring urgent IABP insertion

Four selected cases of emergent IABP insertion in PV patients are presented. After angiographic documentation of critical iliac stenosis, conservative peripheral angioplasty was performed prior to IABP insertion. No patient experienced a peripheral ischemic event associated with IABP use. © 1992 Wiley-Liss, Inc.     

Early diagnosis of SARS: lessons from the Toronto SARS outbreak

The clinical presentation of SARS is nonspecific and diagnostic tests do not provide accurate results early in the disease course. Initial diagnosis remains reliant on clinical assessment. To identify features of the clinical assessment that are useful in SARS diagnosis, the exposure status and the prevalence and timing of symptoms, signs, laboratory and radiographic findings were determined for all adult patients admitted with suspected SARS during the Toronto SARS outbreak. Findings were compared between patients with laboratory-confirmed SARS and those in whom SARS was excluded by laboratory or public health investigation. Of 364 cases, 273 (75%) had confirmed SARS, 30 (8%) were excluded, and 61 (17%) remained indeterminate. Among confirmed cases, exposure occurred in the healthcare environment (80%) or in the households of affected patients (17%); community or travel-related cases were rare (<3%). Fever occurred in 97% of patients by the time of admission. Respiratory findings including cough, dyspnea and pulmonary infiltrates evolved later and were present in only 59, 37 and 68% of patients, respectively, at admission. Direct exposure, fever on the first day of illness, and elevated temperature, pulmonary infiltrates, lymphopenia and thrombocytopenia at admission were associated with confirmed cases. Rhinorrhea, sore throat, and an elevated neutrophil count at admission were associated with excluded cases. In the absence of fever or significant exposure, SARS is unlikely. Other clinical, laboratory and radiographic findings further raise or lower the likelihood of SARS and provide a rational basis for estimating the likelihood of SARS and directing initial management.     

African American older adults coping with chronic health conditions.

This study's purpose is to identify strategies used by community-dwelling African American elders to cope with their chronic health conditions. A focus group study of 28 African American elders with multiple chronic conditions was conducted. Data collection occurred during the last 4 months of 2003. The five focus groups were audiotaped and transcribed verbatim. Content analysis was performed on the data to ascertain coping strategies employed to manage daily life with chronic conditions. Categories of coping strategies identified are (a) dealing with it, (b) engaging in life, (c) exercising, (d) seeking information, (e) relying on God, (f) changing dietary patterns, (g) medicating, (h) self-monitoring, and (i) self-advocacy. This study expands nurses' knowledge of the repertoire of coping strategies used by African American elders to ameliorate the effects of their chronic health conditions. Study findings will be valuable for planning intervention studies aimed at promoting successful coping.     

Scleral show

Scleral show is an anatomical condition in which the sclera area is visibly exaggerated due to constitutional, evolutive, or endocrine etiology. It can also occur because of iatrogenies, and is considered one of the most complex blepharoplasty complications. Its evolution and poor response to treatment are questionable. The defect is not always linked to an ectropion, and the basic differences between the two are explained. During blepharoplasties, in order to avoid iatrogenic scleral show, among other complications, one should take special precautions with the quantity and the exact location of the tarsal portion of orbicularis oculi muscle to be resected.     

Preliminary observations on the activity of progabide, administered as monotherapy in complex partial seizures

Progabide (PGB), a gamma-amino-butyric acid receptor agonist, was administered, according to an open-label long-term design, to 40 adult patients suffering from complex partial seizures, with or without secondary generalization, whose response to carbamazepine (CBZ) monotherapy was unsatisfactory. A reference-baseline period of two months with carbamazepine monotherapy was followed by a two-month "add-on" period where increasing doses of progabide were added without modifying the CBZ regimen; then CBZ was withdrawn over 15-60 days and patients were followed up to 12 months' progabide treatment. Twenty-seven patients completed the trial but 12 of them had to be returned to CBZ + PGB bitherapy due to an increase of seizures following CBZ withdrawal. A definite therapeutic effect could be observed in nine patients on PGB monotherapy and in six patients on CBZ + PGB bitherapy. Side-effects of clinical relevance occurred in three cases and were represented by remarkable anxiety in two patients and a rise in serum glutamic oxalo-acetic acid and pyruvic transaminases with clinical symptoms of liver dysfunction in one, with rapid recovery following progabide discontinuation. In conclusion, progabide was effective against complex partial seizures in about 40% of patients not responding satisfactorily to available antiepileptic drugs. Although the withdrawal of previous antiepileptic drugs was not possible in all patients, progabide monotherapy was sometimes more effective than CBZ monotherapy, and several patients in whom bitherapy had to be restored benefited from the association of progabide.     

Conduction studies in peripheral cat nerve using implanted electrodes: III. The effects of prolonged constriction on the distal nerve segment

Electrophysiological properties were monitored in detail in chronically constricted peripheral nerves by implanted, multicontact nerve cuff electrodes and correlated with morphometric histology in selected cases. The physiological and histological responses in nerve to a range of constricting cuffs of standard sizes were readily graded. The initial response to any significant constriction was a transient, focal conduction slowing or block at the constriction, followed by more protracted distal effects; the latter ranged from loss of excitability consistent with "dying-back" degeneration to reductions in conduction velocity consistent with histologically observed atrophy. Smaller myelinated fibers tended to have similar but less pronounced changes than larger diameter fibers. Recordings from ventral and dorsal roots showed that distal degeneration was more pronounced in motor than in sensory fibers of similar caliber. Electronmicroscopical measurements showed that basal laminas were relatively preserved around even the most atrophic and demyelinated axons. Perimeter measurements of the basal lamina could be used to estimate the diameter of the original nerve fiber.