Clinical characteristics, prognosis, and treatment of pelvic cryptorchid seminoma.

PURPOSE: To analyze the clinical characteristics, prognosis, and treatment outcome of pelvic cryptorchid seminoma (PCS), and to determine whether whole abdominal-pelvic irradiation for Stage I disease is necessary. METHODS AND MATERIALS: From 1958 to 1991, 60 patients with PCS were treated at the Cancer Hospital of Chinese Academy of Medical Sciences, Beijing. They presented with a lower abdominal mass and showed a predominance for the right side. A high proportion of patients with PCS [26 of 60 (43%)] had metastatic disease, compared to 20% of those with scrotal seminoma, and there was a tendency toward a higher frequency of pelvic nodal metastases. There were 34 Stage I, 6 Stage IIA, 11 Stage IIB, 5 Stage III, and 4 Stage IV patients. Of these 60 patients, 56 underwent laparotomy with or without cryptorchiectomy (37 radical orchiectomy, 7 partial orchiectomy, and 12 biopsy of the primary or cervical node), and 4 cervical node biopsy only. All patients were further treated with radiotherapy, chemotherapy, or a combination of both. Patients with Stage I and II disease received radiotherapy, whereas patients with Stage III and IV were treated with chemotherapy. RESULTS: The overall and disease-free survivals at 5 and 10 years were 92% and 87%, and 88% and 84%, respectively. The 5- and 10-year survivals were 100% for Stage I, 94% and 87% for Stage II, and 56% and 42% for Stage III/IV, respectively (p < 0.05). Volume of irradiation, i.e., whole abdominal-pelvic radiotherapy (10 patients), versus hockey-stick encompassing paraaortic, ipsilateral iliac nodes and the primary tumor or tumor bed (17) did not influence outcome in Stage I patients. Five patients relapsed within 2-12 years after treatment, and four of these patients were successfully salvaged. Four patients developed a second malignant tumor and died. CONCLUSION: Stage I and II PCS can be adequately controlled by radiotherapy regardless of the surgical procedure. Whole abdominal-pelvic irradiation for Stage I and IIA disease is not required, and fields can be limited to the paraaortic, ipsilateral iliac nodes and primary tumor or tumor bed. We recommend platinum-based chemotherapy for Stage IIB-IV PCS.

Tillsammans för god vattenstatus : Förvaltningsplan för Kymmene älvs-Finska vikens vattenförvaltningsområde för åren 2016–2021

Förvaltningsplanen för Kymmene älvs-Finska vikens vattenförvaltningsområde innehåller uppgifter om vattnens status samt om de åtgärder som krävs för att förbättra och upprätthålla yt- och grundvattnens status under förvaltningsperioden 2016–2021. Ytvattnens ekologiska status i vattenförvaltningsområdet är svag i synnerhet på de åkerdominerade avrinningsområdena i områdets södra delar och i Finska vikens kustvatten. I vattenförvaltningsområdets norra delar har status försämrats i områden som belastas av diffus belastning och torvutvinning. Åarnas och älvarnas status försämras särskilt av eutrofiering till följd av diffus belastning, men också av byggande, reglering och uppdämning. Ytvattnens kemiska status i vattenförvaltningsområdet har till stor del bedömts vara god. Den sämre än goda kemiska statusen beror i huvudsak på de kvicksilverhalter i abborre som överstiger miljökvalitetsnormen. Grundvattenområden med den sämsta kemiska statusen finns i Nyland och Mellersta Finland. De vanligaste orsakerna till att den kemiska statusen försämrats är grundvattnets kloridhalt, lösningsmedel, bekämpningsmedel samt bensintillsatsen MTBE. De sammanlagda kostnaderna för de åtgärder som föreslås i förvaltningsplanen är 571 miljoner euro per år. Härav är 515 miljoner euro grund- och andra åtgärder som ska vidtas med stöd av annan lagstiftning och 56 miljoner euro åtgärder som kompletterar vattenvården. Lagstiftningsbaserade, ekonomiska, förvaltningsmässiga och informationsmässiga styrmetoder har presenterats för att främja genomförandet av åtgärderna. Ansvarsområdena och samarbetsparterna för genomförandet av styrmetoderna har fastställts.

Caracterização da influência do tipo de sinterização na composição química, resistência à flexão e dureza de blocos cerâmicos para CAD/CAM

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Basic symptoms and the prediction of first-episode psychosis

Recent focus on early detection and intervention in psychosis has renewed interest in subtle psychopathology beyond positive and negative symptoms. Such self-experienced sub-clinical disturbances are described in detail by the basic symptom concept. This review will give an introduction into the concept of basic symptoms and describe the development of the current instruments for their assessment, the Schizophrenia Proneness Instrument, Adult (SPI-A) and Child and Youth version (SPI-CY), as well as of the two at-risk criteria: the at-risk criterion Cognitive-Perceptive Basic Symptoms (COPER) and the high-risk criterion Cognitive Disturbances (COGDIS). Further, an overview of prospective studies using both or either basic symptom criteria and transition rates related to these will be given, and the potential benefit of combining ultra-high risk criteria, particularly attenuated psychotic symptoms, and basic symptom criteria will be discussed. Finally, their prevalence in psychosis patients, i.e. the sensitivity, as well as in general population samples will be described. It is concluded that both COPER and COGDIS are able to identify subjects at a high risk of developing psychosis. Further, they appear to be sufficiently frequent prior to onset of the first psychotic episode as well as sufficiently rare in persons of general population to be considered as valuable for an early detection of psychosis.

Applicability and dosimetric impact of ultrasound-based preplanning in high-dose-rate brachytherapy of prostate cancer

BACKGROUND AND PURPOSE: Analyses of permanent brachytherapy seed implants of the prostate have demonstrated that the use of a preplan may lead to a considerable decrease of dosimetric implant quality. The authors aimed to determine whether the same drawbacks of preplanning also apply to high-dose-rate (HDR) brachytherapy. PATIENTS AND METHODS: 15 patients who underwent two separate HDR brachytherapy implants in addition to external-beam radiation therapy for advanced prostate cancer were analyzed. A pretherapeutic transrectal ultrasound was performed in all patients to generate a preplan for the first brachytherapy implant. For the second brachytherapy, a subset of patients were treated by preplans based on the ultrasound from the first brachytherapy implant. Preplans were compared with the respective postplans assessing the following parameters: coverage index, minimum target dose, homogeneity index, and dose exposure of organs at risk. The prostate geometries (volume, width, height, length) were compared as well. RESULTS: At the first brachytherapy, the matching between the preplan and actual implant geometry was sufficient in 47% of the patients, and the preplan could be applied. The dosimetric implant quality decreased considerably: the mean coverage differed by -0.11, the mean minimum target dose by -0.15, the mean homogeneity index by -0.09. The exposure of organs at risk was not substantially altered. At the second brachytherapy, all patients could be treated by the preplan; the differences between the implant quality parameters were less pronounced. The changes of prostate geometry between preplans and postplans were considerable, the differences in volume ranging from -8.0 to 13.8 cm(3) and in dimensions (width, height, length) from -1.1 to 1.0 cm. CONCLUSION: Preplanning in HDR brachytherapy of the prostate is associated with a substantial decrease of dosimetric implant quality, when the preplan is based on a pretherapeutic ultrasound. The implant quality is less impaired in subsequent implants of fractionated brachytherapy.

[Acute infectious emergencies in adults in medical practice]

Infectious diseases belong to the most frequent reasons to seek emergency care. Life-threatening infectious emergencies, which require rapid diagnosis and hospitalisation, are, however, rare. Leading signs and symptoms are high fever combined with rapidly deteriorating general conditions, hypotonia, tachycardia, tachypnea, dyspnea, confusion, headache, or petechia or information about asplenia, immunosuppression or recent travel to the tropics. Life threatening situations, such as suspicion of invasive meningococcal infection or bacterial infection in an asplenic patient, septic-toxic shock, and acute bacterial meningitis with delayed hospitalisation require rapid start of empiric antibiotic therapy in the outpatient practice. In addition, acute infectious emergencies comprise situation for which post exposure prophylaxis is indicated.

Enchiridion practicum medico-chirurgicum siue de internorum externorumque morborum curatione, breues, sed accurati tractatus duo : I. Incerti, at magni authoris opus postumum ... : II. Anthonij Chalmetei olim apud Anicienses chirurgi celeberrimi Manuale chirurgicum summariis theoricis singulis capitibus praefixis : Opus omnibus tam medicinam quàm chirurgiam facientibus summè necessarium.

Contiene con portada y signatura propias : Enchiridion chirurgicum, externorum morborum remedia tum vniuersalia, tum particularia breuissimè complectens ... authore Antonio Chalmeteo, [7], 351, [7] p.

Enchiridion practicum medico-chirurgicum siue de internorum externorumque morborum curatione, breues, sed accurati tractatus duo : I. Incerti, at magni authoris opus postumum ... : II. Anthonij Chalmetei olim apud Anicienses chirurgi celeberrimi Manuale chirurgicum summariis theoricis singulis capitibus praefixis : Opus omnibus tam medicinam quàm chirurgiam facientibus summè necessarium.

Contiene con portadilla y signatura propias : Enchiridion chirurgicum, externorum morborum remedia tum vniuersalia, tum particularia breuissimè complectens ... authore Antonio Chalmeteo, [8], 351, [7] p.

El fondo de ciencia, tecnología e innovación y la financiación de proyectos regionales

El Acto Legislativo 05 de 2011 modificó los artículos 360 y 361 de la Constitución Política, creando el Sistema General de Regalías (SGR) cuyos recursos se distribuyen, entre otros, al denominado Fondo de Ciencia Tecnología e Innovación (FCTI), el cual se encuentra igualmente ligado al Sistema de Competitividad, Ciencia, Tecnología e Innovación (antes SNCTeI). La creación del FCTI se concibió con la finalidad de destinar recursos provenientes de regalías para la financiación de proyectos regionales que reflejen el uso y la apropiación de la ciencia, la tecnología y la innovación como motor de desarrollo económico y social, por ello las normas sobre la cual se cimienta dicho Fondo deben encaminarse al fortalecimiento no sólo del Estado sino también de las regiones, para lo cual se implementó un proceso de regionalización del SGR. Siendo que los proyectos de inversión deben tener una visión e impacto regional, el trabajo de investigación analiza la relación que existe entre la normativa vigente en torno al FCTI y la financiación de proyectos regionales, identificando las contribuciones y posibles limitaciones en la implementación de dichas normas.

Performance characteristics of automotive engines in the United States. First series--report no. 19. 1975 Ford Windsor 351 CID (5.7 liters), 2V. Interim report.

Transportation Systems Center, Cambridge, Mass.

Helsinki 7/3 1944

Kirje 7.3.1944

Prevalence of ERα-397 PvuII C/T, ERα-351 XbaI A/G and PGR PROGINS polymorphisms in Brazilian breast cancer-unaffected women

Polymorphisms of hormone receptor genes have been linked to modifications in reproductive factors and to an increased risk of breast cancer (BC). In the present study, we have determined the allelic and genotypic frequencies of the ERα-397 PvuII C/T, ERα-351 XbaI A/G and PGR PROGINS polymorphisms and investigated their relationship with mammographic density, body mass index (BMI) and other risk factors for BC. A consecutive and unselected sample of 750 Brazilian BC-unaffected women enrolled in a mammography screening program was recruited. The distribution of PGR PROGINS genotypic frequencies was 72.5, 25.5 and 2.0% for A1A1, A1A2 and A2A2, respectively, which was equivalent to that encountered in other studies with healthy women. The distribution of ERα genotypes was: ERα-397 PvuII C/T: 32.3% TT, 47.5% TC, and 20.2% CC; ERα-351 XbaI A/G: 46.3% AA, 41.7% AG and 12.0% GG. ERα haplotypes were 53.5% PX, 14.3% Px, 0.3% pX, and 32.0% px. These were significantly different from most previously published reports worldwide (P < 0.05). Overall, the PGR PROGINS genotypes A2A2 and A1A2 were associated with fatty and moderately fatty breast tissue. The same genotypes were also associated with a high BMI in postmenopausal women. In addition, the ERα-351 XbaI GG genotype was associated with menarche ≥12 years (P = 0.02). ERα and PGR polymorphisms have a phenotypic effect and may play an important role in BC risk determination. Finally, if confirmed in BC patients, these associations could have important implications for mammographic screening and strategies and may be helpful to identify women at higher risk for the disease.

Adaptación de las pruebas de procesamiento fonológico de una batería neuropsicológica en niños de 5 a 7 años.

Resumen basado en el de la publicación