Staging and surgery in testicular cancer

Both staging and surgery in testicular cancer are thoroughly analysed. Extensive experiences from various authors are reported and compared. The essentials for staging are suggested and a new detailed stage grouping is proposed. The role of surgery in diagnosis, staging and therapy is examined. It is stressed that in non-seminomas, retroperitoneal lymph node dissection is not only a staging procedure, but it may be also a curative operation in several cases of patients with lymph node metastases and a prospective randomized clinical trial is advocated in order to clarify the usefulness of adjunctive chemotherapy in these cases. Surgery is also useful as adjuvant to chemotherapy in several patients with advanced non-seminomas and it is underlined that it should be undertaken early, after only 2 or 3 cycles of chemotherapy, in order to avoid the strong fibrosis that often occurs after long-term chemotherapy and which makes surgical dissection very difficult or even impossible. Lastly, even if extensive, surgery seems to be a safe procedure in these young patients.     

Coproduction of Regan isoenzyme and carcinoembryonic antigen in HCT-8 cells

Five groups of adult Ss were submitted to free-recall learning of 24 objects presented as written nouns for the control group and as pictures for experimental groups, as follows: schematic black and white, schematic colored, detailed black and white, and detailed colored drawings. Pictures were better recalled than nouns. Recall was significantly inferior for schematic black and white than for detailed colored drawings, with schematic colored and detailed black and white drawings at an intermediate level. These results support the so-called incidental-cues hypothesis according to which the best recall of pictures in comparison with that of nouns is partially the result of pictures having more distinctive cues likely to be encoded than do verbal items.     

Lower esophageal sphincter function in children with and without gastroesophageal reflux

Resting lower esophageal sphincter (LES) pressure was assessed in infants and children 2 weeks to 12 years of age. There were 62 control subjects and 35 patients with reproducible gastroesophageal reflux (GER) determined radiologically. In control subjects without GER: (1) LES pressure was well developed by 2 weeks of age; (2) in children less than 1 year of age, mean LES pressure (43.3 +/- 2.4 mm Hg) was significantly greater than mean LES pressure (30.6 +/- 2.3 mm Hg) children older than 1 year of age; (3) LES sphincter length increased with age; and (4) bethanechol 0.1 mg per kg subcutaneously caused a rise in LES pressure that increased in magnitude as LES resting pressures increased. In patients with GER: (1) only 16 or 35 children had LES pressures below the normal range for their appropriate age group; (2) LES length was shorter than control values in children beyond 6 months of age; (3) GER usually occurred in the absence of hiatus hernia; (4) clinical improvement was common and in patients with low LES pressure was associated with a rise in LES pressures to normal, even in the presenece of hiatus hernia; and (5) bethanechol caused a change and an absolute rise in LES pressure that were not significantly different from those observed in controls. These results indicate that in infants and children low LES pressure is not the sole determinant of GER, and that pharmacological stimulation of the Les could prove to be a useful adjunct to the medical management of GER.     

Effect of vitamin A on the systemic and local antibody responses to intragastrically administered bovine serum albumin

The effects of vitamin A on the immune response to bovine serum albumin (BSA) were studied in adult mice. Treatment with vitamin A by the intragastric or parenteral routes markedly increased the local as well as the systemic antibody response to different concentrations of the antigen (BSA). In contrast, in animals given BSA alone, antigen concentrations above a certain dose resulted in a decreased or even absent anti-BSA response. These studies suggest that vitamin A may be an appropriate adjuvant in oral immunization.     

Alternate-day prednisone therapy in recipients of renal allografts. Risk and benefits

Forty-five patients receiving renal allografts were gradually converted from daily to alternate-day prednisone therapy. Indications for conversion included aseptic necrosis, growth retardation in children and adolescents, obesity, diabetes, cataract formation, and cosmetic appearance. Eight of the 45 patients developed acute or chronic rejection during or just after completion of alternate-day steroid therapy. The remaining 37 patients had a notable decrease in the degree of hypercorticism, with return of growth in children and adolescents. However, there was no improvement once aseptic necrosis or cataract formation had occurred. Although the use of alternate-day prednisone therapy is of benefit in reducing the untoward side effects of corticosteroids, the risk of precipitating allograft rejection is a significant threat and must be carefully considered whenever this form of treatment is undertaken.     

Treatment of end-stage renal disease by transplantation: clinical results with 111 cases

The efficacy of renal transplantation for patients with end-stage renal disease was reviewed in 108 patients receiving 111 transplants followed for an average of two and one-half years after transplantation. Overall patient survival decreased 10 per cent per year from 90 per cent after the first year to 70 per cent at three years. Kidney survival was slightly less, with a similar pattern. Patients with better tissue matches and living related donor allografts had fewer and less severe rejections and better ultimate function than did patients with poor tissue matches and cadaver allografts. However, a significant number of patients with poor tissue matches and cadaver allografts had excellent results. Eighty-six per cent of all survivors with functioning kidneys had serum creatinines of 2.0 mg./100 ml. or below. Mortality was associated primarily with sepsis from a variety of bacterial, fungal, viral and protozoan organisms often associated with other complications such as rejection or gastrointestinal bleeding. Recipients over the age of 40 were in a higher risk group. Rejection per se, however, played a minor role. Urological and skeletal complications were a major source of morbidity but were not associated with mortality.     

Team approach to total parenteral nutrition

The organization, function, and results of a total parenteral nutrition (TPN) team consisting of a surgical staff physician, a senior surgery resident, a nurse and a pharmacist are described. The TPN team has treated 160 patients. The incidence of septicemia as a complication of TPN has been less than 1% and the rate of serious metabolic derangements of TPN has been 2.7% for electrolyte aberrations and 5% for significant glycosuria in this series. It is recommended that hospitals that cannot provide such a team should refer patients requiring TPN to a center with a TPN team.     

Evaluation of 2-benzylidenecyclohexanones and 2,6-bis(benzylidene)cyclohexanones for antitumor and cytotoxic activity and as inhibitors of mitochondrial function in yeast: metabolism studies of (E)-2-benzylidenecyclohexanone

Some 2-benzylidenecyclohexanones, 2,6-bis(benzylidene)cyclohexanones, and related compounds were evaluated for antitumor and cytotoxic activities; (E)-2-benzylidenecyclohexanone (Ia) was shown to have significant cytotoxic properties and a potent inhibitory effect on yeast mitochondria. After intraperitoneal injection of Ia, unchanged drug and a metabolite, tentatively identified as 2-(p-hydroxybenzyl)cyclohexanol, were found in the urine. No metabolites were found in the feces. Oral administration of Ia afforded three unidentified metabolites in the urine and three unidentified metabolites in the feces.     

Sephadex LH-20 multiple-column chromatography for the simultaneous separation of progesterone, deoxycorticosterone and 17alpha-hydroxyprogesterone from small plasma samples

The effects of exogenous prolactin and hypophysectomy were tested on Na exchange across the gills of Tilapia mossambica adapted to sea-water. Exogenous prolactin produced a 75% decrease of both total Na influx and Na efflux. Total Na influx was measured simultaneously with the drinking rate. Water ingestion stopped almost completely in prolactin-treated fish. Thus branchial net excretion flux of Na was reduced 75% by prolactin. Hypophysectomy produced a 50% inhibition of Na efflux across the gill.