ABSTRACT
PURPOSE: We compare general and disease specific health related quality of life in men undergoing brachytherapy for early stage prostate cancer to those undergoing radical prostatectomy and age matched healthy controls. MATERIALS AND METHODS: Cohorts consisted of 48 men treated with brachytherapy with and without pretreatment external beam radiation therapy (brachytherapy group), 74 who underwent radical prostatectomy (prostatectomy group) and age matched healthy controls from the literature. The RAND 36-item general health survey, University of California Los Angeles Prostate Cancer Index, American Urological Association symptom index, validated Cancer Interference with Life and Family Scales, and sociodemographic and co-morbidity questionnaires were completed 3 to 17 months after treatment. RESULTS: General health related quality of life did not differ greatly among the 3 groups. Urinary function (leakage) was worse in the brachytherapy group than in controls but better than in the prostatectomy group. Brachytherapy group patients had more irritative urinary symptoms and worse bowel function than controls. Sexual function and bother were worse in prostatectomy and brachytherapy groups than in healthy controls. Physical function, bodily pain, urinary function, and bother and American Urological Association symptom index scores improved with time after brachytherapy. Patients who underwent brachytherapy after external beam radiation performed worse in all general and disease specific health related quality of life domains compared to those who did not undergo pretreatment radiation therapy. CONCLUSIONS: At an average of 7.5 months after treatment the general health related quality of life of patients undergoing brachytherapy with and without pretreatment external beam radiation was similar to age matched controls, although urinary, bowel and sexual problems were reported. These problems appeared to improve during the first year after treatment. Much of the impairment in disease specific health related quality of life among patients undergoing brachytherapy may be attributed to pretreatment radiation.
Subject(s)
Brachytherapy , Prostatic Neoplasms/pathology , Prostatic Neoplasms/radiotherapy , Quality of Life , Aged , Cross-Sectional Studies , Humans , Male , Middle Aged , Neoplasm Staging , Prostatectomy , Prostatic Neoplasms/surgery , Retrospective StudiesABSTRACT
A 10-year-old girl with the human immunodeficiency virus was found to have a Staphylococcus aureus renal abscess with perinephric extension. The abscess was drained first percutaneously and then surgically, and the patient received a 6-week course of intravenous antibiotics. Three months later, the abscess recurred, necessitating a nephrectomy. The extended morbidity and difficulty of eradicating S aureus suggest that, in immunocompromised patients, early aggressive surgical management is indicated.
Subject(s)
AIDS-Related Opportunistic Infections/therapy , Abscess/microbiology , Kidney Diseases/microbiology , Staphylococcal Infections/therapy , AIDS-Related Opportunistic Infections/microbiology , Abscess/therapy , Anti-Bacterial Agents , Child , Drainage , Drug Therapy, Combination/therapeutic use , Female , HIV Seropositivity , Humans , Kidney Diseases/therapy , Nephrectomy , RecurrenceABSTRACT
BACKGROUND/AIMS: Intestinal epithelial cells present protein antigens to primed T cells in vitro. The aim of this study was to investigate whether intestinal epithelial cells present peptide antigens in vitro and in vivo after oral administration. METHODS: Small intestinal epithelial cells from naive LEW (RT1) rats pulsed in vitro with a synthetic immunogenic major histocompatibility complex allopeptide, RT1.Du beta 20-44, or in vivo by oral administration of the peptide were tested for their ability to induce specific proliferation of LEW T cells primed in vivo to RT1.Du beta 20-44. RESULTS: In vitro pulsed intestinal epithelial cells induced specific proliferation of RT1.Du beta 20-44-primed T cells. Intestinal epithelial cells isolated from LEW ras that received a single oral dose of RT1.Du beta 20-44 18 hours earlier also induced specific proliferation of RT1.Du beta 20-44-primed LEW T cells. Furthermore, epithelial cells harvested from LEW rats that received WF (RT1u) splenocytes orally 18 hours earlier induced specific proliferation of RT1.Du beta 20-44-primed LEW T cells. CONCLUSIONS: Intestinal epithelial cells take up processed alloantigen in vitro and in vivo for presentation as peptides to primed T cells. These observations provide a novel approach to study the role of the intestinal immune system in immune regulation in vivo.
