Teaching patients INs and OUTs.

When patients don't understand how to care for their chronic illness, frequent hospitalization results. One example is the patient who is admitted to a medical nursing unit in end stage renal disease (ESRD), the common complications of which are hypervolemia, hypovolemia and associated electrolyte imbalances. To prevent further disease progression and frequent hospitalization, an accurate measurement of fluid intake and output is critical, as is the patient's ability to understand and take responsibility for his/her own care.

[Laparoscopic vs. open surgical lymphadenectomy in prostate cancer. Methodological comparison]. / Laparoskopische vs. offenchirurgische Lymphadenektomie beim Prostatakarzinom. Ein Methodenvergleich.

Bilateral laparoscopic pelvic lymph node dissection was performed in 27 consecutive patients with stage B prostatic carcinoma. The first 5 operations (learning phase) were compared with the next 22 procedures and with a group of 20 patients who had undergone conventional open lymphadenectomy previously. Retropubic radical prostatectomy was done in 22 patients with negative nodes. All residual lymphatic tissue was removed. During the learning phase the average operating time was 3 h 40 min. The mean number of laparoscopically removed nodes was 5.8 on both sides. At open operation we found 1.5 residual nodes on the right side and 5.3 residual nodes on the left. In one case one of the residual nodes was positive for tumor. Operating time in the next 22 patients was 2 h 20 min. The number of nodes removed laparoscopically was 8.3 on the right and 7.0 on the left. Residual nodes were found in only 3 patients. None of these nodes was positive for tumor. In both groups the number of nodes removed was greater than in the group of patients who underwent open lymphadenectomy. In one of the first 5 patients immediate open surgery was required because of bleeding. In 1 patient's nodes evidence of Hodgkin disease was found. This was the only patient to develop a lymphatic fistula. There were no lymphoceles. We feel that laparoscopic pelvic lymphadenectomy has a definite learning curve but is a safe staging procedure for prostatic cancer with results equivalent to those of the open operation.

[Cutaneous drug reaction caused by suramin in 4 patients with metastatic prostate cancer]. / Kutane Arzneimittelreaktion durch Suramin bei 4 Patienten mit metastasierendem Prostata-Karzinom.

Suramin has long been used in the treatment of onchocerciasis and trypanosomiasis. Recent investigations showed an antiproliferative effect of suramin on prostate carcinoma cell lines. Ongoing clinical trials have confirmed the effect of suramin on metastasizing prostate carcinoma. Five patients with metastatic prostate carcinoma resistant to classic hormonal therapy were treated with high-dose suramin. Four of the five developed a papulovesicular or maculopapular rash within 2-4 weeks of starting therapy. The rashes disappeared after discontinuation of suramin within 10 days. In tumour therapy, high dosages of suramin are used to achieve a serum level of 200-300 micrograms/ml. Therefore, a toxic reaction to suramin is suspected as the explanation for the skin rashes.

Dose-related effects of nerve growth factor (NGF) on choline acetyltransferase (ChAT), acetylcholine (ACh) content and ACh turnover in the brain of newborn rats.

Dose-effect relations of ?-nerve growth factor (NGF) have been established on the induction of choline acetyltransferase (ChAT) in basal forebrain nuclei, striatum, cortex and hippocampus of newborn rats after single intracerebroventricular (i.c.v.) injections. Doses above 2 ?g were maximally effective in each of the four brain regions. With the same doses and in the same time course acetylcholine (ACh) concentrations were elevated in the same brain regions. ChAT activity was increased up to 220% in the septum, 200% in the striatum, 160% in the cortex and 120% in the hippocampus. The ACh concentration was elevated up to 175% in the septum, 140% in the striatum, 130% in the cortex and 117% in the hippocampus. The incorporation of labelled choline into ACh showed an increase in ACh turnover of about 60% after i.c.v. application of 5 ?g NGF. Unspecific effects of NGF on brain growth have been excluded. NGF may possibly be useful for the treatment of memory and cognitive impairment as in senile dementia of Alzheimer's type.

Simple and rapid method for the determination of progesterone in rat plasma by gas-liquid chromatography with electron-capture detection.

A method for estimating progesterone in rat plasma using gas-liquid chromatography (GLC) with electron-capture detection is described. By means of a column chromatographic technique for the extraction of progesterone from plasma, it is possible to isolate the steroid in such a specific way that, contrary to previously published methods, no additional chromatographic purification and separation steps are needed prior to the final GLC analysis. As a derivative for electron-capture detection we used the 3,20-di-O-pentafluorobenzyloxime of progesterone. This derivative is superior to those used hitherto with regard to sensitivity and stability. The high overall recovery (mean value, 89.4%) makes this method especially convenient for research work when only little plasma is available, or when the concentration of progesterone is very low.

An improved extraction method for plasma steroid hormones.

An easy and rapid column chromatographic method for the extraction of steroid hormones from plasma is presented. It permits the nearly quantitative separation of the steroids in a single step with smaller expenditure of time and work as compared to the usual liquid-liquid extraction. Problems of emulsions are eliminated. Furthermore, fractionated separation of hormones from plasma is possible. A simple procedure for the selective extraction of estriol (isolated from estrone and estradiol) is described.

Effect of ovarian sex hormones on the pool of free amino acids in maternal tissues of pregnant rats fed a protein-free diet.

The effects of s.c. injections of 5 mug oestrone/kg and 50 mg progesterone/kg on Days 5-7 of gestation were investigated in rats fed a protein-free diet. The decrease in essential and non-essential amino acid concentrations in maternal liver and the implantation site caused by dietary protein deficiency was restored to control values, whereas the alterations of the plasma free amino acid concentrations, except for arginine and glycine, were not reversed by hormone treatment.