Biochemical control and toxicity for favorable- and intermediate-risk patients using real-time intraoperative inverse optimization prostate seed implant: Less is more!

PURPOSE: To report the biochemical control rate and clinical outcomes with real-time inverse planning (inverse optimization prostate seed implant [IO-PSI]) for favorable-risk (FR) and intermediate-risk (IR) prostate adenocarcinoma in a community practice setting. This analysis is an extended followup of our initial report, with favorable early biochemical control rate (biochemical nonevidence of disease) of 97% at 4 years. METHODS AND MATERIALS: Three hundred fifty-seven evaluable patients with FR and IR prostate cancer underwent real-time IO-PSI (iodine-125/145 Gy or palladium-103/120 Gy) between 2001 and 2013. RESULTS: With a median followup of 54 months (range, 24-110 months), the absolute biochemical failure free survival of disease was 96%. The 8-year actuarial probability of prostate-specific antigen failure-free survival for FR and IR cohorts was 92.4% and 87%, respectively. Late genitourinary and gastrointestinal toxicity remained low. Late Grade 2 and Grade 3 genitourinary toxicity was 19% and 1%, respectively. Late Grade 2 and 3 rectal bleeding rates were 1% and 0%, respectively. No difference in biochemical control was observed with preimplant short course androgen deprivation or between Gleason score 3 + 4 vs. 4 + 3 patients. No dosimetric parameter was predictive of biochemical failure. Patients with FR had a significantly decreased risk of failure (hazard ratio = 0.26; 95% confidence interval = 0.09-0.78; p = 0.02) compared with those with IR. Patients with a prostate-specific antigen nadir >0.4 ng/mL had an increased risk of failure (hazard ratio = 1.37; 95% confidence interval = 1.27-1.47; p < 0.0001). CONCLUSIONS: Our initial biochemical and clinical outcomes using real-time IO-PSI persisted with extended followup and support our original hypothesis for use of a reduced number of sources, needles, and total activity, suggesting that with IO, less is more.

MN1 overexpression is an important step in the development of inv(16) AML.

The gene encoding the transcriptional co-activator MN1 is the target of the reciprocal chromosome translocation (12;22)(p13;q12) in some patients with acute myeloid leukemia (AML). In addition, expression array analysis showed that MN1 was overexpressed in AML specified by inv(16), in some AML overexpressing ecotropic viral integration 1 site (EVI1) and in some AML without karyotypic abnormalities. Here we describe that mice receiving transplants of bone marrow (BM) overexpressing MN1 rapidly developed myeloproliferative disease (MPD). This BM also generated myeloid cell lines in culture. By mimicking the situation in human inv(16) AML, forced coexpression of MN1 and Cbfbeta-SMMHC rapidly caused AML in mice. These findings identify MN1 as a highly effective hematopoietic oncogene and suggest that MN1 overexpression is an important cooperative event in human inv(16) AML.

Guided visualization and suggestibility: effect of perceived authority on recall of autobiographical memories.

The purpose of this study was to investigate a possible component process in the formation of childhood pseudomemories in adults. Participants recounted a childhood event, the details of which came from hearing others tell it (a know event) rather than from their personal experience (a remember event). Then participants were placed in 1 of 4 possible conditions: They completed a guided visualization task led by an expert, a guided visualization task led by a nonexpert, a visual search task, or a verbal list-learning task. For the guided visualization task, participants listened to a middle-aged man on audiotape, who asked them to imagine details about their know event. Half believed the person on the tape was a well-known and esteemed psychologist (an expert), and half were led to believe that he was someone who had gone back to school to study communications (a nonexpert). As predicted, guided visualization led participants to rate their know event closer to a remember event. Planned comparisons demonstrated that the effect was significantly greater for the expert versus nonexpert conditions. Results were applied to the process of false memory formation and the use of visualization procedures in psychotherapy.

When knowing becomes remembering: individual differences in susceptibility to suggestion.

In two experiments, the authors explored factors that might influence a person's tendency to make source-monitoring errors about autobiographical memories. In the first experiment, undergraduates retrieved a memory from childhood (a) that was known about but not remembered, (b) that was remembered, or (c) for which they were unsure of their memory's source. After writing down the memory, experimental groups listened to a guided visualization tape and answered questions about the event--interventions designed to help them focus on details of their memory. Controls also retrieved and wrote down a memory; however, instead of visualizing the memory, they were instructed to conduct a visual search task. Results indicated that guided visualization led participants to rate known memories closer to remembered events. A second experiment examined individual difference variables that might be related to this know-to-remember shift. Results indicated that extraversion, external locus of control, a memory that conveyed fear, and overall affective content predicted this rating. The applicability of these findings to the psychotherapy process is discussed.

[Association of chronic obstructive bronchitis and upper digestive pathology. A clinical study]. / Associazione tra bronchite cronica ostruttiva e patologia digestiva alta. Contributo clinico.

The association of chronic obstructive pulmonary disease (COPD) with esophageal-gastric and duodenal disease is very common. In our experience 21.8% of patients with COPD were affected by peptic ulcer and 50.9% by inflammatory disease of upper digestive tract. This association appears independent from smoking and alcohol abuse. Dyspepsia and corticosteroid therapy were associated with endoscopic lesions (dyspepsia was present in 75.6% of patients with abnormal endoscopy vs 42.8% without endoscopic lesions, p less than 0.01 and corticosteroid therapy in 43.9% vs 0, p less than 0.001). On the contrary therapy with theophylline and beta 2-adrenoceptor-agonists is not associated with digestive disease. Spirometric parameters and blood gas analysis were not different among patients with and without endoscopic lesions. We suggest endoscopy of upper digestive tract in patients affected by COPD with dyspepsia and/or corticosteroid therapy.

[Three-dimensional reconstruction on the personal computer of lesions of the central nervous system]. / Ricostruzione tridimensionale al personal computer di lesioni a carico del sistema nervoso centrale.

This study presents results obtained using section counting system to examine intact as well as lesioned structures in the rat S.N.C. This new approach consists in the utilization of a television camera projecting magnified brain sections directly on the computer monitor screen. Tridimensional reconstructions and rapid evaluations of volume, area and other parameters are then available by means of this system.

[Conditioning system for training cats to execute a typical prehension movement]. / Sistema per il condizionamento del gatto alla esecuzione di un tipico movimento di prensione.

This report describes a conditioning system for training cats to carry-out typical prehension's movements which exhibit the highest degree of reproducibility. It is composed of the following: a) a cage which is furnished with a particular foot-board to check the starting position of the front legs; b) an electropneumatic machine for transporting a bit of food; c) an electronic device for controlling and randomizing the time of nourishment.

[Electronic circuit for the control of current intensity of stimulating impulses at high isolation]. / Circuito elettronico per il controllo della intensita' di corrente di impulsi stimolanti ad elevato isolamento.

A small electronic apparatus is described, in which the pulses of current can be regulated from 0 at 10 mA. This apparatus permits the utilization of conventional tension stimulators.

[Semiautomatic regulator for the preparation of microelectrodes for electrophysiology]. / Dispositivo semiautomatico per la preparazione di microelettrodi per elettrofisiologia.

This paper describes an electronic device for making metallic microelectrodes to be used for electrophysiological experiments. These microelectrodes are endowed with a small tissue-electrode capacity and a high mechanical strength. The same microelectrodes are applicable for derivation of spikes as in the case of microstimulation of nervous structures during repeated penetrations.