Chemotherapy in advanced prostate cancer.

In the United States, prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer death in men. Prostate cancer is a rare disease before age 40; however, the prevalence increases quickly to 80% by the age of 80, and with increasing life expectancy, hormone-refractory prostate cancer (HRPC) will soon represent the most common cancer in the male population in the United States and other Western countries. The evolution of early prostate cancer is variable and extends over many years; some tumors progress slowly or not at all, whereas others may progress more rapidly and be fatal after a few years.

CD38/ADP-ribosyl cyclase: A new role in the regulation of osteoclastic bone resorption.

The multifunctional ADP-ribosyl cyclase, CD38, catalyzes the cyclization of NAD(+) to cyclic ADP-ribose (cADPr). The latter gates Ca(2+) release through microsomal membrane-resident ryanodine receptors (RyRs). We first cloned and sequenced full-length CD38 cDNA from a rabbit osteoclast cDNA library.

Heparin-induced thrombocytopenia in coronary bypass surgery.

We report on a 51-year-old man with severe two-vessel coronary disease and an ejection fraction of 15% who presented with myocardial ischemia and heparin-induced thrombocytopenia after coronary angioplasty. Before coronary bypass surgery, the antithrombin agent argatroban was used for anticoagulation and an intraaortic balloon pump was inserted. Direct coronary bypass surgery was performed to the left anterior descending artery and to the posterior descending artery using the 'Octopus' tissue stabilization device (Manfrotto, Feltre, Italy).

The effects of peripheral vascular disease on gait.

This study was designed to determine whether patients with peripheral vascular disease (PVD) have gait abnormalities. A previous study on humans with PVD found no abnormalities whereas significant gait changes were seen with a rat model of PVD. The study population was comprised of 10 controls and 9 subjects with PVD (all male).

Cyclooxygenase-2 alters transforming growth factor-beta 1 response during intestinal tumorigenesis.

Background: Recent investigation suggests that cyclooxygenase-2 plays an important role in colorectal carcinogenesis. Transforming growth factor-beta1 (TGF-beta 1) is one of the most potent stimulators of cyclooxygenase-2 expression. A key step in intestinal tumorigenesis involves alteration of the normal cellular response to TGF-beta 1.

Intraspinal delivery of neurotrophin-3 using neural stem cells genetically modified by recombinant retrovirus.

Neural stem cells have been shown to participate in the repair of experimental CNS disorders. To examine their potential in spinal cord repair, we used retroviral vectors to genetically modify a clone of neural stem cells, C17, to overproduce neurotrophin-3 (NT-3). The cells were infected with a retrovirus construct containing the NT-3.

Cardiovascular effects of acute and chronic cocaine administration in pregnant and nonpregnant rabbits.

The effects of cocaine administration on cardiovascular parameters were studied in anesthetized nonpregnant and pregnant rabbits with no prior exposure to cocaine and in pregnant rabbits repeatedly administered cocaine (4 mg/kg, bid, iv) for 15-20 days prior to the experiment. Rabbits were instrumented to determine the effects of cocaine on blood pressure, heart rate, and organ blood flows. Administration of the 1 and 2 mg/kg doses of cocaine increased blood pressure and decreased heart rate in both pregnant and nonpregnant rabbits.

Rhinocerebral mucormycosis: a case of a rare, but deadly disease.

Rhinocerebral mucormycosis is a rare fungal infection of the nasal cavity and sinuses that can spread to the orbits and cranium within days. Its presentation can be confused with those of sinusitis, viral infections, diabetic ketoacidosis, or carotid sinus thrombosis, and it is often missed at early presentation. Survival is directly linked to early detection and treatment.

A prospective, randomized study comparing the results of open discectomy with those of video-assisted arthroscopic microdiscectomy.

Background: The usefulness of video-assisted arthroscopic microdiscectomy for the treatment of a herniated lumbar disc has been studied previously. In the current prospective, randomized study, the results of this procedure were compared with those of conventional open laminotomy and discectomy.

Methods: Sixty patients who had objective evidence of a single intracanalicular herniation of a lumbar disc caudad to the first lumbar vertebra were randomized into two groups consisting of thirty patients each; Group 1 was managed with open laminotomy and discectomy, and Group 2 was managed with video-assisted arthroscopic microdiscectomy.

Implantable cardioverter-defibrillator follow-up: what everyone needs to know.

Over the past few years, remarkable advances in the treatment of ventricular tachycardia, ventricular fibrillation, and sudden cardiac death have occurred. One of the most significant treatment modalities has been the addition of the implantable cardioverter-defibrillator (ICD). Because of the rapidly expanding indications for ICD therapy, it is common for internists, family practitioners, emergency room physicians, and general cardiologists to treat defibrillator patients.

Mg2+-dependent modification of the N-methyl-D-aspartate receptor following graded hypoxia in the cerebral cortex of newborn piglets.

The present study tests the hypothesis that Mg2+ modification of N-methyl-D-aspartate receptor ion channel opening is altered during hypoxia and correlates with the progressive decrease in cerebral energy metabolism induced by hypoxia. Studies were performed in five normoxic and nine hypoxic ventilated piglets. In the hypoxic group, varying degrees of cerebral energy metabolism were achieved by administration of different fractions of inspired oxygen (FiO2) (5-9%) for varying durations of time and were documented by cortical tissue phosphocreatine levels.

Pontine regulation of pelvic viscera: pharmacological target for pelvic visceral dysfunctions.

The pathophysiology and pharmacological targets of disorders of the bladder and colon have focused predominantly on the periphery. However, these viscera are regulated by the CNS, which, in turn, must integrate their functions with compatible behaviours. This review focuses on the role of the pontine micturition centre, Barrington's nucleus, as a key to this integration.

A pediatric clinical skills assessment using children as standardized patients.

Objectives: To develop and implement a pediatric clinical skills assessment (PCSA) for residents, using children as standardized patients (SPs); to assess the psychometric adequacy of the PCSA and use it to evaluate the performance of residents; and to evaluate the feasibility of using child SPs and the response of the residents and the child SPs to participation in the PCSA.

Methods: Ten 22-minute complete patient encounters were developed, 7 with child SPs. Fifty-six residents (10 second-year pediatric residents, 29 first-year pediatric residents, and 17 first-year family practice residents) were evaluated on the following clinical skills: history taking, physical examination, interpersonal skills, and documentation and interpretation of clinical data/patient note.

Peripheral arterial occlusion in acute promyelocytic leukemia.

A 16-year-old Caucasian teenager developed fatigue, abdominal pain, pneumonia, and subsequently acute vascular occlusion of the left superficial femoral artery. Vascular assessment and heparin therapy lead to bone marrow aspiration and a diagnosis of acute promyelocytic leukemia. Treatment with chemotherapy prevented loss of limb and avoided further vascular surgery.

The selective effects of alcohol on automatic and effortful memory processes.

Automatic and effortful memory processes were evaluated in a 2-session, within-subjects design involving an alcohol challenge and a no-alcohol condition. Free recall of a 90-word list measured effortful processing. Estimation of word frequency from the same list measured automatic processing.

Usefulness of Telfa pads in the histologic assessment of stereotactic-guided breast biopsy specimens.

Stereotactic core-needle biopsies (SCNBs) are being increasingly used for the diagnosis of breast lesions. Focal mammographic calcifications are often considered significant and sampled by SCNB. We compared diagnostic outcomes in breast tissue cut from 59 core biopsy blocks using Telfa pad embedding with those of 48 routinely embedded blocks.

Transplants of fibroblasts genetically modified to express BDNF promote regeneration of adult rat rubrospinal axons and recovery of forelimb function.

Adult mammalian CNS neurons do not normally regenerate their severed axons. This failure has been attributed to scar tissue and inhibitory molecules at the injury site that block the regenerating axons, a lack of trophic support for the axotomized neurons, and intrinsic neuronal changes that follow axotomy, including cell atrophy and death. We studied whether transplants of fibroblasts genetically engineered to produce brain-derived neurotrophic factor (BDNF) would promote rubrospinal tract (RST) regeneration in adult rats.

Thrombospondin 1 and its specific cysteine-serine-valine-threonine-cysteine-clycine receptor in fetal wounds.

Thrombospondin 1 (TSP-1), an adhesive glycoprotein, plays an important role in platelet adhesion, inflammation, cell-cell interaction, and angiogenesis. TSP-1 is expressed by endothelial cells, fibroblasts, and macrophages. The unique cysteine-serinevaline-threonine-cysteine-glycine (CSVTCG) binding domain of TSP-1 also plays an important role in cell binding and modulation of cellular processes.

Long-term regulation of locus ceruleus sensitivity to corticotropin-releasing factor by swim stress.

Corticotropin-releasing factor (CRF) acts as a putative neurotransmitter in the locus ceruleus (LC) to mediate its activation by certain stressors. In this study, we quantified LC sensitivity to CRF 24 h after swim stress, at a time when behavioral depression that is sensitive to antidepressants is apparent. Rats were placed in a tank with 30 cm (swim stress) or 4 cm water and 24 h later, either behavior was monitored in a forced swim test or LC discharge was recorded.

In vivo determination of altered hemoglobin saturation in dogs with M-type phosphofructokinase deficiency.

Muscle-type phosphofructokinase (M-PFK) deficiency causes an exertional myopathy and chronic hemolysis in affected humans and dogs, the only animal model available. Deficient individuals have impaired glycolytic metabolism, impaired oxidative metabolism, and increased hemoglobin-oxygen (HbO2) affinity as a result of low 2,3-diphosphoglycerate (2,3-DPG) levels. The purpose of this study was to determine if PFK-deficient muscle has abnormal oxygen saturation during exercise.

Necrotizing fasciitis: an uncommon consequence of pressure ulceration.

Pressure ulcers may occur in patients with chronic illnesses, especially in those who are bed-bound or chair-bound. Local measures usually suffice to allow primary ulcer healing and support skin grafting or tissue transfer reconstruction. On rare occasions, however, pressure ulcers may progress to invasive infection and necrosis of adjacent soft tissues, possibly leading to necrotizing fasciitis.

A current activated on depletion of intracellular Ca2+ stores can regulate exocytosis in adrenal chromaffin cells.

Exocytosis in excitable cells is strongly coupled to Ca2+ entry through voltage-gated channels but can be evoked by activation of membrane receptors that release Ca2+ from inositol 1,4, 5-trisphosphate-sensitive internal stores. In many cell types, depletion of Ca2+ stores activates Ca2+ influx across the plasma membrane, a process known as capacitative or store-operated Ca2+ entry. This influx is mediated by a number of voltage-independent, Ca2+-selective currents.

A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims.

Ninety-six female assault victims with chronic posttraumatic stress disorder (PTSD) were randomly assigned to 4 treatment conditions: prolonged exposure (PE), stress inoculation training (SIT), combined treatment (PE-SIT), or wait-list control (WL). Treatment consisted of 9 twice-weekly, individual sessions. Independent evaluations were conducted at pretreatment; posttreatment; and 3-, 6-, and 12-month follow-ups.

Inpatient reports of suspected child abuse or neglect (SCAN): a question of missed opportunities in the acute care setting.

Objective: To determine reasons inpatient reports of suspected child abuse or neglect (SCAN) were not initiated at the time of evaluation in the acute care setting.

Design: Retrospective case series.

Setting: Urban children's hospital.

Lambert-Eaton antibodies inhibit Ca2+ currents but paradoxically increase exocytosis during stimulus trains in bovine adrenal chromaffin cells.

Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune disease that affects neurotransmitter release at peripheral synapses. LEMS antibodies inhibit Ca2+ currents in excitable cells, but it is not known whether there are additional effects on stimulus-secretion coupling. The effect of LEMS antibodies on Ca2+ currents and exocytosis was studied in bovine adrenal chromaffin cells using whole-cell voltage clamp in perforated-patch recordings.