Permanent prostate brachytherapy for Japanese men: Results from initial 100 patients with prostate cancer

OBJECTIVE: To evaluate the initial results of brachytherapy for prostate cancer with permanent iodine-125 implant in Japan. METHODS: The results obtained with brachytherapy in the initial 100 Japanese patients treated at Nagano Municipal Hospital were reviewed. Patients with a prostate-specific antigen (PSA) level of less than 10 ng/mL and a Gleason's scores of 5, 6, 3 + 4 were classified as having a low risk of recurrence. Patients with a PSA level of 10-20 ng/mL and/or a Gleason's score of 4 + 3 were classified as having an intermediate risk for recurrence. Seventy-eight of the low-risk patients and 19 of the intermediate-risk patients were treated by seed implants alone, or seed implants combined with preceding external radiation, respectively. A total of 53 patients received neoadjuvant hormone therapy. The efficacy and morbidity of brachytherapy were investigated using the serum PSA, International Prostate Symptom Score, quality of life score and uroflowmetry data. RESULTS: The average V100 and D90 obtained by post-implant dosimetry was 94.3 and 113.7%, respectively. Serum PSA decreased gradually after treatment, although it had still not reached a nadir after 1 year. There was little difference of the PSA level between the patients with and without neoadjuvant hormone therapy even at 1 year after seed implantation. There were no PSA biochemical failure or clinical recurrence during the follow-up period. Voiding symptoms worsened until 3 months after treatment, and then gradually improved. Acute urinary retention occurred transiently in one patient (1%). Rectal bleeding and severe diarrhea did not occur. CONCLUSION: Brachytherapy is a feasible and effective option for the treatment of prostate cancer in Japanese men. Brachytherapy may have a different effect in Japanese patients with respect to voiding symptoms. Urinary retention was rare, but voiding symptoms were persistent in Japanese patients. Neoadjuvant hormone therapy deserves investigation to determine whether it can achieve better results, especially in patients with an intermediate risk.     

LOWER POSTPRANDIAL PLASMA GLUCOSE AND INSULIN AFTER ADDITION OF ACACIA CORIACEA FLOUR TO WHEAT BREAD

Many Australian Aboriginal bushfoods contain slowly digested carbohydrate which elicit low postprandial blood glucose and insulin responses compared to Western foods, such as wheat bread. This study has shown that incorporation of flour made from a slowly digested seed, Acacia coriacea , into wheat bread (18 g/82 g wheat flour) significantly reduces the initial rise in plasma glucose levels ( p < 0.05) and the area under the plasma glucose curve ( p < 0.005) in six healthy subjects. Insulin values were also lowered at 60 minutes ( p < 0.025) and 90 minutes ( p < 0.05). Our findings suggest that Acacia flour, when used to dilute wheat flour in the manufacture of breads, produces a very palatable food which could be useful in the diets of diabetic individuals.     

放射性125I粒子组织间植入或联合放化疗治疗复发直肠癌

目的探讨超声或CT引导下放射性125I粒子组织间植入治疗复发直肠癌的技术可行性、近期疗效和副反应.方法 15例直肠癌术后盆腔复发患者,女4例,男11例.硬膜外麻醉,2例经阴道超声引导,13例CT引导,行放射性125I粒子植入术.肿瘤匹配周边剂量为90～110 Gy,每颗粒子活度为0.50～0.70 mCi,植入33～70颗.术后24～48 h拍胸、盆腔X线片了解粒子是否发生移位.术后6例加三维适形放疗,4～6野/次,200～300 cGy/次,5次/周,总剂量为4 500～5 000 cGy,间隔4周.2例粒子治疗后加草酸铂、5-氟尿嘧啶和四氢叶酸化疗1个周期,随访3～15个月,根据CT扫描结果判断肿瘤大小. 结果术后平均7天疼痛缓解,其中12例完全缓解,2例部分缓解,1例无变化,有效率93%(14/15).9例肿瘤完全缓解,2例部分缓解,4例局部进展,局部控制率73%(11/15).2例术后6个月和12个月时死于肺转移.1例1颗粒子移位至盆壁,随访12个月无症状.无治疗相关并发症和副作用发生. 结论经超声或CT引导放射性125I粒子植入治疗复发直肠癌具有安全、微创、并发症发生率低和疗效肯定等优势,粒子治疗后应配合外放疗和全身化疗,有望进一步提高疗效.     

车前子对高脂血症大鼠脂质过氧化的影响

目的 :　探讨车前子对高脂血症大鼠脂质过氧化的影响。方法 :　采用大鼠血清及多脏器组织 ,观察车前子对高脂血症大鼠脂质过氧化的影响。结果 :　高脂对照组血清和心肌超氧化物歧化酶 ( SOD)活性显著降低 ,而脂质过氧化物 ( LPO)含量明显升高 ,血清和肝脏的过氧化氢酶( CAT)、谷胱苷肽过氧化物酶 ( GSH-Px)活性明显降低。补充车前子后显著升高血清及心肌组织SOD活性 2 2 %和 2 8% ,以及肝脏 GSH-Px活性 2 2 %。而使血清及心肌的 LPO含量分别下降 3 2 %和 1 7%。结论 :　 1 5 g/kg车前子可提高高脂血症大鼠体内抗氧化能力并免受自由基损伤     

氮芥抗药性人早幼粒白血病HL60细胞亚系的建立及其生物特性

用逐步递增药物浓度和软琼脂细胞克隆技术，药物连续作用１４个月后获得氮芥（ＨＮ２）抗药性人早幼粒白血病ＨＬ６０细胞亚系，抗件达５～７倍（ＨＬ６０／ＮＨ２６），在无ＨＮ２培养液中５倍以上抗性维持１０个月以上，抗性细胞亚系的生物学特性除倍增时间稍长和克隆形成率略低外其生长曲线，细胞周期细胞ＤＮＡ指数，形态学，组织化学和染色体分析均与亲代细胞相似。     

手助腹腔镜胆肠、胃肠内引流术联合125I粒子置入术治疗晚期胰腺癌

目的探讨手助腹腔镜胆肠、胃肠内引流术联合125I粒子置入术治疗晚期胰腺癌的可行性和临床疗效. 方法2002年2月～2004年8月,我院行手助腹腔镜胆肠、胃肠内引流术联合125I粒子置入术治疗晚期胰腺癌12例(胰头癌10例,胰体癌2例). 结果 12例手术均获成功.手术时间104～181 min,(122±29) min.术中出血量45～152 ml,(60±18) ml.住院时间6～17 d,(8.5±1.3) d.术后病人黄疸逐渐减退,术后7～10 d肝功能恢复正常.腹痛消失3例,明显缓解7例.2例出现胃肠功能障碍,治疗后缓解.10例术后随访6个月复查CT肿瘤明显缩小(PR)4例,无变化(NC)4例,肿瘤进展(PD) 2例. 结论手助腹腔镜内引流术联合癌组织间125I粒子置入术是治疗晚期胰腺癌,使其缓解症状的有效方法,具有创伤小、恢复快、能改善病人生活质量.     

125I粒子组织间种植对人胃癌裸鼠移植瘤的杀伤作用

目的 观察不同剂量^125I粒子对人胃癌裸鼠移植瘤的杀伤作用及组织损伤。方法 建立人胃癌BGC-823细胞裸鼠皮下移植瘤模型，随机分为对照组和实验组，将不同剂量（100、120、140Gy）地^125I粒子植于实验组。30、60d：比较移植瘤抑瘤率，病理组织学、局部皮肤反应、裸鼠体重及白细胞计数。结果30d，100、120、140Gy组抑瘤率分别为51．93％、79．18％、90．22％，病理组织学反应程度多为RCRG2（45．83％），各实验组组间除120Gy与140Gy（P〉O．05）组外，及分别与对照组比较，差异有统计学意义（P〈0．05）；局部皮肤反应各实验组与对照组比较，差异有统计学意义（P〈0．05），各实验组组间差异无统计学意义（P〉0．05）。60d，各组抑瘤率分别为97．97％、100％、96．69％，病理组织学反应程度以RCRG1居多（62．5％），与对照组比较，差异均有统计学意义（P〈0．05），各实验组组间差异无统计学意义（P〉0．05）；局部皮肤反应随剂量增高而加重，各实验组组间及其分别与对照组比较，差异有统计学意义（P〈0．05）。结论 不同剂量的^125I粒子在不同时间对人胃癌裸鼠皮下移植瘤有显著杀伤作用，但120Gy和140Gy组随剂量累积，损伤明显增加。提示100Gy可能是治疗人胃癌裸鼠皮下移植瘤的有效剂量。     

The treatment of sulphur mustard burns with laser debridement.

The chemical warfare agent, sulphur mustard (SM), is a potent blistering agent in man. Skin exposure can produce partial-thickness burns which take up to three months to heal. The aim of this study was to investigate the use of early laser ablation as a means of accelerating this exceptionally slow rate of healing. Four circular partial-thickness SM burns were induced on the dorsum of nine large white pigs (under general anaesthesia). At 72 h post-exposure, three burns per animal were ablated with a single pass of an UltraPulse 5000C CO(2) laser, at a fluence of 5-6 J cm(-2). All the burns were dressed with silver sulphadiazine and a semi-occlusive dressing. At one, two and three weeks post-surgery three animals were culled and all lesions excised for histological analysis. Burn depth was confirmed and measurements of the radii of regenerative epithelium were performed allowing the area of the zone of re-epithelialisation in each lesion to be calculated. Laser-treated lesions showed a significant increase (350%) in healing rates compared to controls (p<0.005). At two weeks, the laser-treated sites were 95% healed in comparison with control sites (28% healed). These data suggest that laser ablation may be effective in the treatment of partial-thickness SM-induced skin injury.     

放射性~(125)I粒子组织间植入对家兔尿道损伤的实验研究

目的:研究不同剂量的放射性125I粒子对家兔尿道的放射性损伤。方法:麻醉下将放射性125I粒子植入雄性家兔尿道旁1.0cm处。125I粒子的放射性粒子活度分别为14.8MBq(A组)、29.6MBq(B组)和44.4MBq(C组),对照组(D组)仅尿道旁种植相当于粒子大小无放射性的无菌铅管1粒。植入后4周,摄尿道片,观察粒子位置等情况;原手术切口切开,取放射粒子周围2.0cm范围内的家兔尿道组织作肉眼、光学显微镜和电子显微镜观察,进行放射性损伤的评价。结果:术后4周,肉眼及光学显微镜观察,实验组与对照组粒子周围的尿道粘膜、粘膜下及肌层所见基本一致;C组少部分电镜视野中观察到尿道上皮胞质出现较多空泡变性、空化、嵴稀疏等超微结构的损伤。光镜下尿道入射性损伤评分,A、B、C、D组分别为(2.20±0.18)、(2.23±0.15)、(2.27±0.10)、(2.10±0.17)分,A、B、C组与D组相比,差异无显著性(P>0.05)。对线粒体作FlaMeng半定量分析,A、B、C、D各组评分分别为(1.23±0.13)、(1.34±0.25)、(1.41±0.30)、(1.12±0.13)分,A、B、C各组与D组(对照组)相比,差异无显著性(P>0.05)。结论:放射性125I粒子对尿道放射性损伤随粒子的放射性活度的增加而逐渐加重,呈明显的放射性活度效应关系;正常剂量的放射性粒子对尿道的损伤是很轻微的,是安全可行的。