A Novel Nomogram to Identify Candidates for Extended Pelvic Lymph Node Dissection Among Patients with Clinically Localized Prostate Cancer Diagnosed with Magnetic Resonance Imaging-targeted and Systematic Biopsies

Background

Available models for predicting lymph node invasion (LNI) in prostate cancer (PCa) patients undergoing radical prostatectomy (RP) might not be applicable to men diagnosed via magnetic resonance imaging (MRI)-targeted biopsies.

Dorsal fracture of the hamate: distinctive radiographic appearance

Six patients who injured their wrists had radiographs documenting a dorsal, 5- to 10-mm oblong fragment of bone immediately proximal to the base of the fourth and/or fifth metacarpal bones. The fragment was seen on the pronation oblique and/or lateral projections, but not on the posteroanterior projection. The radiographic appearance of the fragment was remarkably similar in all cases. In the one patient in which it was performed, pluridirectional tomography demonstrated that the fragment originated from the dorsal surface of the hamate. Five of the six patients also had associated posterior dislocation of the fourth and/or fifth metacarpals. We conclude that this fragment represents a coronal fracture through the body of the hamate resulting from posterior dislocation or subluxation of the fourth and/or fifth metacarpal.     

Myosin light chains and muscle pathology

We evaluated the isoform composition of heavy and light chains of myosin in single muscle fibers from patients with Duchenne dystrophy, myotonic dystrophy, or polymyositis. In all myopathic muscles, there was an increase in the proportion of intermediate fibers which, by analysis of myosin isoforms, fell into two subpopulations, one that contained both fast and slow myosin and another that contained myosin molecular hybrids. The increased proportion of intermediate (or transitional) fibers suggests changes in the equilibrium between fast and slow motor units. These changes could result from regeneration and subsequent maturation of fibers or from direct transformation of mature fibers of one type into the opposite.     

美托洛尔治疗老年冠心病慢性心力衰竭52例疗效观察

目的评价β-受体阻滞剂治疗老年冠心病慢性心力衰竭的疗效及安全性。方法105例老年冠心病慢性心力衰竭患者按就诊顺序随机分为两组，美托洛尔组52例在常规抗心力衰竭治疗基础上加用美托洛尔12．5～25mg，2／d；对照组53例采用常规抗心力衰竭治疗，未用美托洛尔。定期来诊随访，观察临床表现，监测治疗前后心率、血压、心功能参数变化。结果美托洛尔组显效率53．8％，总有效率88．5％；对照组显效率30．2％，总有效率67．9％，两者比较有显著性差异（P〈0．05）。美托洛尔组患者心率减慢、血压降低较对照组明显，超声心动图复查显示治疗6个月后左室舒张末期内径缩小，左室射血分数增高较对照组显著。结论美托洛尔为老年冠心病慢性心力衰竭提供一种较为安全有效的药物治疗手段。     

Older adults’ preferences for exercising alone versus in groups: Considering contextual congruence

Background: A growing body of research suggests that older exercisers prefer to exercise alone rather than in group-based settings. One limitation of these studies, however, has been that researchers have failed to take into account the age-related characteristics of groups when asking adults about their preferences for exercise settings.Purpose: The overall purpose of this study was to examine the exercise preferences of 947 adults for involvement in standard exercise classes populated by participants from various categories across the age spectrum.Results: The results revealed that when faced with the prospect of exercising with considerably older or younger exercisers, participants found such an exercise context to be largely unappealing. However, in accordance with the basic tenets of self-categorization theory, the results revealed that older and younger adults alike express a positive preference for exercising in standard exercise classes comprised of similarly aged participants.Conclusions: The findings of this study challenge a growing call for exercise interventions for older adults to be primarily directed at the individual-level, and suggest that group-related intervention strategies may indeed be attractive to older exercisers.