Pathologic seminal vesicle invasion after radical prostatectomy for patients with prostate carcinoma: effect of early adjuvant radiation therapy on biochemical control

BACKGROUND: The authors evaluated the effect of postoperative radiation therapy on freedom from biochemical failure (bNED) in men with prostate carcinoma who had pathologic seminal vesicle invasion after radical prostatectomy and negative pelvic lymph node dissection (pT3cN0). METHODS: Between 1989 and 1995, 375 men underwent radical prostatectomy at Thomas Jefferson University Hospital. Fifty-three men (13%) had pT3cN0 prostate carcinoma and were the subject of this analysis. Men in whom prostate specific antigen (PSA) could not be detected were deemed free of biochemical failure. RESULTS: Of the 53 men with pT3cN0 prostate carcinoma, 18 had an elevated PSA immediately after surgery and received salvage radiation therapy (RT). The 3-year bNED rate for this group was only 38%. At 3 months, PSA could not be detected in the other 35 men. Fifteen of those 35 men underwent early adjuvant RT, and the other 20 were observed for biochemical failure. The 3-year bNED rate for the 15 patients treated with immediate adjuvant RT was 86%, compared with 48% for the 20 men who were observed (P = 0.01). CONCLUSIONS: These data suggest that early adjuvant RT for men with pT3cN0 prostate carcinoma and no detectable PSA postoperatively reduces the likelihood of future biochemical failure. Men with pT3cN0 prostate carcinoma and a persistently elevated postoperative PSA level are less likely to benefit from RT and should be considered for systemic therapy.     

Percutaneous aspiration liver biopsy using a large-caliber disposable needle: a preliminary report

A modification of the aspiration liver biopsy technique using a large-caliber disposable needle is described in an 18-month experience. One hundred forty liver biopsies were performed, obtaining adequate tissue in 98% of the patients. Complications occurred in 12 patients and were limited to pain at the biopsy site, epigastrium, or right shoulder; one instance of tachycardia and three of transient hypotension occurred. Thirty patients studied prospectively with liver scans and hematologic parameters failed to disclose subclinical complications. While the number of patients biopsied is still too small to provide definite conclusions , it appears that this technique is safe, similar and has a very high yield of excellent specimens. In addition, the needle offers the advantage of being disposable and easy to use by a single operator.     

Lean NOx Trap Chemistry Under Lean-Gasoline Exhaust Conditions: Impact of High NOx Concentrations and High Temperature

The primary technical barrier to deployment of fuel saving lean gasoline engines is NOx emissions control. We conducted automated flow reactor experiments on a commercial LNT catalyst to identify opportunities and challenges associated with the higher temperatures and higher NOx concentrations expected in lean gasoline applications. Overall NOx conversion was quite high at low to moderate temperatures, but dropped off at high temperatures. The decrease in NOx conversion with temperature was worse for higher inlet NOx concentrations. As expected from equilibrium considerations, the catalyst stored more NOx under higher gas phase NOx concentrations, but that NOx was rapidly released during the rich phase and slipped out of the catalyst before it could be converted to N₂ by incoming reductant. This rich phase NOx release was the primary factor limiting performance of the catalyst at high temperatures, and resulted in significant spikes of NOx that would likely exceed any not-to-exceed regulated emissions levels. N₂O production was also significant, and increased with NOx concentration. The catalyst made very little NH₃ at high temperatures. NH₃ yield was significant at the lowest operating temperature studied, but it decreased with increasing NOx concentration.     

Robustness Testing of a Tablet Formulation Using Multivariate Design

ABSTRACT

A total of 45 experiments were carried out to evaluate the robustness of two similar tablet formulations—a product of two strengths—with respect to normal batch-to-batch variation of the excipients and the active pharmaceutical ingredient. The formulations consist of 10 ingredients. Because of the differing amounts of active pharmaceutical ingredients, the two formulations also differ in the amounts of two of the diluents and one of the binders. The excipients and active pharmaceutical ingredient were characterized in terms of multiple variables, and principal properties were calculated with principal component analysis. A Plackett and Burman design was applied to the principal properties. The relationships between the design factors and two responses, mean disintegration time and mean crushing strength, were evaluated by using regression methods. Both formulations were found to be robust under controlled conditions.     

Effects of alcohol on psychophysiological hyperreactivity to nonaversive and aversive stimuli in men at high risk for alcoholism.

Psychophysiological reactivity to nonaversive (1-KHz, 70-db tones) and aversive stimuli (shock) was examined in nonalcoholic men with multigenerational family histories (MFH) of alcoholism and family history negative (FH–) men, while sober and after consuming alcohol. In comparison with FH– Ss, sober MFH Ss had significantly larger skin conductance (SC) orienting responses (ORs), shorter OR latencies, slower habituation rates to the tones, and larger increases in heart rate and vasoconstriction to the shock. Alcohol dampened the magnitude of the SC-OR to the tones and the degree of cardiovascular reactivity to the shocks and increased the habituation rate to the tones in MFH Ss only. Alcohol consumption also increased the SC-OR recovery time in FH– Ss only. The MFH Ss' pattern of psychophysiological hyperreactivity is discussed in terms of a potential dysfunction in stimulus–response regulation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy of brief coping skills interventions that match different personality profiles of female substance abusers.

Female substance abusers recruited from the community were randomly assigned to receive 1 of 3 brief interventions that differentially targeted their personality and reasons for drug use. The 90-min interventions were: (a) a motivation-matched intervention involving personality-specific motivational and coping skills training, (b) a motivational control intervention involving a motivational film and a supportive discussion with a therapist, and (c) a motivation-mismatched intervention targeting a theoretically different personality profile. Assessment 6 months later (N?=?198) indicated that only the matched intervention proved to be more effective than the motivational control intervention in reducing frequency and severity of problematic alcohol and drug use and preventing use of multiple medical services. These findings indicate promise for a client-treatment matching strategy that focuses on personality-specific motives for substance abuse. (PsycINFO Database Record (c) 2010 APA, all rights reserved)