Progression detection of stage I nonseminomatous testis cancer on surveillance: implications for the followup protocol

PURPOSE: To optimize followup in patients with stage I nonseminomatous testis cancer on surveillance we evaluated the contribution of each followup modality to the detection of progression as well as morbidity and mortality outcomes. MATERIALS AND METHODS: After orchiectomy 170 patients with clinical stage I nonseminoma were prospectively placed on a surveillance protocol. History, physical examination, serum tumor markers, abdominal and pelvic computerized tomography (CT), and chest x-ray were used for followup. The number of failures, methods and timing of progression detection, treatments required, mortality rate and subsequent contralateral primary tumors were recorded. RESULTS: The 170 surveillance patients were followed a median of 6.3 years. Within 2 years (median 6.9 months) postoperatively 48 patients (28.2%) had disease progression. History, physical examination, markers, CT and chest radiography provided the initial evidence of progression in 18 (37.5%), 34 (70.8%), 34 (70.8%), and 4 (8.3%) patients, respectively. Each modality was the only indicator of failure in 2 (4.2%), 4 (8.3%), 10 (20.8%) and 0 cases, respectively. Of the 170 patients 122 (71.8%) required no additional treatment beyond orchiectomy, 26 (15.3%) received 1 and 22 (12.9%) underwent more than 1 therapeutic modality. Only 1 patient (0.6%) died of disease. Contralateral tumors developed in 5 cases (2.9%) therapeutic a mean of 8.1 years after orchiectomy. CONCLUSIONS: In stage I nonseminoma patients, surveillance history, physical examination, tumor markers and abdominopelvic CT are necessary components of the followup protocol. Removal of routine chest x-ray from the protocol would not have changed progression detection. The initial surveillance visit must occur by 2 months postoperatively. Patients should be followed beyond 5 years and likely for life in addition to regular patient self-examination.     

Correlation of theaflavins content and valuations of kenyan black teas

Correlation between theaflavins content and tasters' valuations of Kenyan black teas generally give positive but statistically non-significant correlation coefficients. In 105 correlations using 12 samples each, only eight analyses gave statistically significant (P?0.05) correlations. Theaflavins contributed positively towards valuations but Kenyan black plain teas have high and possibly above optimum theaflavins content. Consequently other factors appear to play major roles in tea pricing, for example the generally higher prices realised by Kenyan black plain teas compared to Malawi black plain teas can only be partly attributed to the higher theaflavins content of the Kenyan teas.     

Design of a Research Performance Measurement System: The Case of NIAB

At NIAB, a UK based company that provides research, services and information to the agricultural and food sector, a system has been designed that helps to assess and manage the growing research programme of the company. Since the company was ‘privatised’ four years ago, research activities have increased and moved away from solely applied research to a mix of applied and more fundamental research. Being a key element of the new developed company strategy, research now plays an increasing important role in broadening the scope of the company and keeping current services competitive by driving innovation. All research at NIAB is externally funded. In this paper we report on the process to design NIAB’s performance measurement system, for which the Performance measurement system Systematic Design Approach was used. The design process was started with an elaborate structured problem analysis of the research process and its inter and extra–organisational context. Based upon this analysis, firstly a conceptual and secondly a detail design of a performance measurement system was made. To maximise the leverage from research, the system has been designed to optimise the value delivered to the funder as well as the value delivered to internal customers in the form of knowledge that drives innovation.     

Implications of traumatic brain injury for survivors of sexual abuse: A preliminary report of findings.

The authors' purpose for presenting these cases is to report on some clinical observations that may have relevance for a subgroup of individuals recovering from a traumatic brain injury. Specifically, the authors observe that a group of patients who reported histories of childhood sexual trauma and then sustained a TBI as adults are experiencing a reemergence of intrusive recollections and other symptoms related to the abuse. Further, the appearance of these posttraumatic stress-type symptoms—sometimes after years of nonoccurrence—frequently proves disruptive to the patient's rehabilitation process. Possible structural, chemical, and phenomenological factors are discussed. The authors' observations raise the possibility that individuals who have made the best recoveries from childhood sexual trauma are the most vulnerable to the reemergence of posttraumatic stress disorder symptoms subsequent to the TBI. These provisory observations would suggest that sensitive inquiry regarding abuse history should be considered as part of any clinical interview with patients who have sustained neurological trauma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

31P NMR studies of unsonicated aqueous dispersions of neutral and acidic phospholipids. Effects of phase transitions, p2H and divalent cations on the motion in the phosphate region of the polar headgroup

1. The 129 MHz (non-proton decoupled) and 36.4 MHz (proton decoupled) 31P NMR spectra arising from unsonicated aqueous dispersions of well defined species of phospholipid have been investigated. The phospholipids employed (and the parameters varied) include phosphatidylcholine (temperature), phosphatidylethanolamine (temperature), phosphatidic acid (temperature and p2H) and phosphatidylglycerol (temperature, p2H and Ca2+ (or Mg2+)) concentration. 2. At p2H = 7 the 31 P MNR spectra arising from saturated species of phosphatidylcholine, phosphatidylethanolamine and phosphatidylglycerol become progressively broader as the temperature is reduced below the phase transition, demonstrating reduced motion in the phosphate region of the polar headgroup. 3. In the liquid crystalline state at p2H = 7 the molecular dipolar order parameters obtained for saturated species of phosphatidylcholine, phosphatidylethanolamine and phosphatidylglycerol and very similar, and are independent of the acyl chain length for species derived from lauric and myristic acid. Thus the motion in the methylene-phosphate-methylene region is similar for these different liquid crystaline phospholipid species. 4. The 31 P NMR spectra of aqueous dispersions of 14:0/14:0 phosphatidic acid display anomalous temperature and p2H dependences. The effective chemical shift anistropy (delta v CSA EFF) at 5 degrees C varies from 71 ppm at p2H = 8.5 to 38 ppm at p2H = 2.5. Further, the motion in the phosphate region is relatively insensitive to the gel or liquid crystalline nature of the hydrocarbon chains. 5. The addition of 40 mol% Ca2+ (or Mg2+) to saturated species of phosphatidylglycerol causes an increase of approx. 20 degrees C in the hydrocarbon phase transition temperature as indicated by 31 P NMR. Equimolar concentrations of Ca2+ increase the transition temperature by approx. 70 degrees C, and no 31P NMR signal could be observed for the very condensed precipitate formed below this temperature. In the liquid crystalline state the motion in the phosphate region of the polar headgroup is not significantly affected by the presence of Ca+ or Mg2+. 6. The 31P NMR spectra obtained from 18 : 1c/18 : 1c phosphatidylethanolamine are consistent with a phase transition from a lamellar to an hexagonal (HII) phase in the region 10-15 degrees C. 7. The observed narrowing of the 31 P NMR spectra of aqueous dispersions of phospholipids as the temperature is raised toward the hydrocarbon transition temperature is discussed in terms of the "pretransition" observed in calorimetric studies.     

Nodal Failure Index Approach to Groundwater Remediation Design

Computer simulations often are used to design and to optimize groundwater remediation systems. We present a new computationally efficient approach that calculates the reliability of remedial design at every location in a model domain with a single simulation. The estimated reliability and other model information are used to select a best remedial option for given site conditions, conceptual model, and available data. To evaluate design performance, we introduce the nodal failure index (NFI) to determine the number of nodal locations at which the probability of success is below the design requirement. The strength of the NFI approach is that selected areas of interest can be specified for analysis and the best remedial design determined for this target region. An example application of the NFI approach using a hypothetical model shows how the spatial distribution of reliability can be used for a decision support system in groundwater remediation design.