Intraoperative 125I brachytherapy for high-risk stage I non-small cell lung carcinoma.

Purpose: Preliminary assessment of feasibility, efficacy, acute and chronic side effects associated with permanent intraoperative placement of 125I vicryl mesh brachytherapy in a select group of high-risk Stage I NSCLC who have undergone video-assisted thoracoscopic resection (VATR).

Methods And Materials: From January 8, 1997 to March 16, 1998, 23 patients with Stage I NSCLC at high risk for conventional surgery due to cardiopulmonary compromise underwent combined VATR and intraoperative placement of 125I seeds embedded in vicryl mesh. Seeds embedded in vicryl suture were attached with surgical clips to a sheet of vicryl mesh, and thoracoscopically inserted over the target area (tumor bed and staple line) with nonabsorbable suture or surgical clips.

The absent mind: further investigations of sustained attention to response.

We have previously demonstrated that performance on a brief and conceptually simple laboratory task (the Sustained Attention to Response Test: SART) was predictive of everyday attentional failures and action slips in brain injured patients and normal control participants. The SART is a go-no-go paradigm in which the no-go target appears rarely and unpredictably. Performance on this measure was previously interpreted as requiring sustained attention to response rather than a putative 'response inhibition' capacity.

Nitric oxide and potassium chloride-facilitated striatal dopamine efflux in vivo: role of calcium-dependent release mechanisms.

Previous studies investigating the calcium-dependency of nitric oxide-facilitated striatal dopamine efflux have produced conflicting results. In the current study, we have investigated the role of extracellular calcium in nitric oxide and potassium chloride-evoked striatal dopamine efflux in vivo using microdialysis. Dialysis probes were implanted in the anterior dorsal striatum of chloral hydrate-anesthetized rats.

Intraoperative brachytherapy following thoracoscopic wedge resection of stage I lung cancer.

Study Objectives: Local recurrence is high when sublobar resection is chosen as primary management of stage I non-small cell lung carcinoma. Postoperative external-beam radiotherapy may reduce this local recurrence problem. A technique of intraoperative brachyradiotherapy following thoracoscopic wedge resection is described as an alternative to adjuvant external-beam radiotherapy for high-risk patients who are not candidates for pulmonary lobectomy.

Platelet activation during dobutamine stress echocardiography.

Background: Dobutamine stress echocardiography (DSE) is a common, useful test for the evaluation of coronary artery disease. Two of 650 patients who underwent DSE at our institution sustained nonfatal myocardial infarction either during DSE or shortly thereafter. Although DSE is associated with low morbidity rates, this rate is higher than our experience with exercise treadmill testing (ETT).

Endogenous nitric oxide facilitates striatal dopamine and glutamate efflux in vivo: role of ionotropic glutamate receptor-dependent mechanisms.

We have investigated the influence of the nitric oxide synthase (NOS) substrate, NG-hydroxy-L-arginine (H-ARG) on dopamine (DA) and glutamate (GLU) efflux in vivo using concentric microdialysis probes implanted in the anterior-medial striatum of chloral hydrate-anesthetized rats. Intrastriatal infusion of H-ARG (100 microM, 200 microM, or 1 mM for 120 min) increased DA efflux in a dose-dependent fashion. The facilitatory effect of H-ARG (1 mM) on DA efflux was abolished following pretreatment (80 min) with the constitutive NOS inhibitor 7-nitroindazole (7-NI, 10 microM) but unaffected by L-NG(1-iminoethyl) lysine (100 microM) infusion.

Effect of red wine on endothelium-dependent relaxation in rabbits.

1. Published data on the effects of red wine, ethanol and flavonoids on endothelium-dependent relaxation are equivocal. The present study was undertaken to determine the effects of red wine, ethanol and selected flavonoids present in red wine on endothelium-dependent relaxation.

Haematologists in district general hospitals practise evidence based medicine.

A study published by the Centre for Evidence Based Medicine in Oxford, demonstrated that 82% of primary interventions offered by a general medical team in a 1 month period were evidence based. This contrasted with the traditional view that only 10-20% of medical interventions offered to patients have any scientific foundation. We have carried out a prospective study to determine if the primary interventions we offer to patients are evidence based.

The efficacy of regional anesthesia for outpatient anterior cruciate ligament reconstruction.

Arthroscopically assisted anterior cruciate ligament (ACL) reconstruction is a common orthopaedic procedure. Until recently, the majority of these procedures have been performed on an impatient basis. This retrospective study evaluated 67 consecutive patients who underwent an arthroscopically assisted, autogenous bone-patellar ligament-bone ACL reconstruction that was supervised by the same surgeon.

The use of an all oral chemotherapy (idarubicin and etoposide) in the treatment of acute myeloid leukaemia in the elderly: a report of toxicity and efficacy.

Acute myeloid leukaemia (AML) is predominantly a disease of the elderly but such patients are not always appropriate candidates for intensive intravenous (i.v.) based treatment regimens.

Inhibition of glutamate reuptake potentiates endogenous nitric oxide-facilitated dopamine efflux in the rat striatum: an in vivo microdialysis study.

The current study investigated the effects of the nitric oxide synthase (NOS) substrate, N(G)-hydroxy-L-arginine (H-ARG) and the selective glutamate (GLU) reuptake inhibitor (2S)-trans-pyrrolidine-2,4-dicarboxylic acid (PDC) on striatal dopamine (DA) and glutamate (GLU) efflux in vivo. Concentric microdialysis probes were stereotaxically implanted in the anterior-medial striatum of chloral hydrate-anesthetized rats. Intra-striatal infusion of PDC (200 microM) elevated extracellular (EC) DA and GLU levels concurrently over a 10 fraction collecting period without affecting EC asparagine levels.

CHOP-based chemotherapy is as effective as alternating PEEC/CHOP chemotherapy in a randomised trial in high-grade non-Hodgkin's lymphoma. Scotland and Newcastle Lymphoma Group.

The aim of this study was to test whether survival for patients with high-grade non-Hodgkin's lymphoma (NHL) can be improved with a non-cross-resistant regimen as compared to a CHOP-based regimen. This is a multicentre study comprising 325 adult patients, median age 58 years, with high-grade non-Hodgkin's lymphoma: patients of any age and performance status were eligible provided they were able to receive the drugs in the regimens. Patients were randomised to either B-CHOP-M (bleomycin, cyclophosphamide, doxorubicin, vincristine, prednisolone and methotrexate) or PEEC-M (methylprednisolone, vindesine, etoposide, chlorambucil and methotrexate) alternating with B-CHOP-M.

Acute myocardial infarction associated with dobutamine stress echocardiography.

Acute myocardial infarction as a complication of dobutamine stress echocardiography (DSE) is described in two patients during or shortly after undergoing the procedure. Both clinical events resulted in characteristic elevations in cardiac enzymes and the development of new electrocardiographic Q waves in the inferior leads. Subsequent coronary angiography was performed in both cases; one patient required two-vessel coronary artery bypass grafting to his first obtuse marginal and posterior descending arteries, and the other underwent successful angioplasty of an occluded proximal right coronary artery.

Hepatitis C virus infection rate in volunteer blood donors from the Western Cape--comparison of screening tests and PCR.

Introduction: Hepatitis C virus (HCV) antibody seroprevalence studies overestimate the true infection rate. No data exist on the incidence of HCV or its clinical features in blood donors of sub-Saharan Africa.

Aims: To establish the true incidence of HCV infection in volunteer blood donors in the Western Cape, and compare risk factors and clinical and biochemical features of viraemic and non-viraemic subjects.

Interactions between cocaine and (-)-DS 121: studies with 2-deoxyglucose autoradiography and microdialysis in the rat brain.

(-)-DS 121 [S-(-)-3-(3-cyanophenyl)-N-n-propyl piperidine], a dopamine autoreceptor preferring antagonist, has been shown to stimulate locomotor activity and induce conditioned place preference. However, the drug fails to facilitate intracranial self-stimulation or substitute for cocaine in cueing experiments, and it blocks cocaine self-administration. In the present study using 2-deoxyglucose autoradiography, (-)-DS 121 (at 50 but not 15 mg/kg i.

MDMA induced dopamine release in vivo: role of endogenous serotonin.

Acting as a substrate at the serotonin (5-HT) transporter, (+)-MDMA (3,4-methylenedioxymethamphetamine), is a potent releaser of 5-HT and causes toxicity to 5-HT neurons after repeated exposure. (+)-MDMA also releases dopamine (DA), although with less potency. Since we have shown previously that the intrastriatal application of 5-HT facilities DA release, it was hypothesized that increased release of striatal 5-HT after MDMA may influence extracellular levels of DA.

Repeated cocaine exposure attenuates the ability of 5-hydroxytryptamine to release striatal dopamine in vivo.

Cocaine was administered repeatedly to rats and striatal microdialysis performed 1, 7, 14, or 21 days after the last cocaine injection. Local perfusion of 10 microM serotonin (5-hydroxytryptamine, 5-HT) increased basal dopamine levels approximately 7-fold (664 +/- 79%, 813 +/- 104% and 669 +/- 22%, n = 6, P < 0.0001) in saline-treated controls, whereas in cocaine-treated animals the effect was significantly attenuated (432 +/- 55%, 465 +/- 61% and 497 +/- 48% n = 6-10, P < 0.

Posterior cruciate ligament reconstruction. An in vitro study of femoral and tibial graft placement.

We studied posterior cruciate ligament reconstruction in a cadaveric model using two substitutes: a 1-mm diameter flexible cable and an 11-mm diameter Achilles tendon autograft. The thin cable allowed us to study five femoral and five tibial attachments in each knee. A nearly isometric attachment was located after cutting the posterior cruciate ligament while the tibia was reduced with a 100 N anterior force.