Treatment of localized prostate cancer using a combination of high dose rate Iridium-192 brachytherapy and external beam irradiation: initial Australian experience.

Combination high dose rate brachytherapy (HDRB) and external beam radiation therapy is technically and clinically feasible as definitive treatment for localized prostate cancer. We report the first large Australian experience using this technique of radiation dose escalation in 82 patients with intermediate- and high-risk disease. With a median follow up of 3 years (156 weeks), complications were low and overall prostate-specific antigen progression-free survival was 91% using the American Society for Therapeutic Radiology and Oncology consensus definition. The delivery of hypofractionated radiation through the HDRB component shortens overall treatment time and is both biologically and logistically advantageous. As a radiation boost strategy, HDRB is easy to learn and could be introduced into most facilities with brachytherapy capability.

A protocol of early spiral computed tomography for the detection of stones in patients with renal colic has reduced the time to diagnosis and overall management costs.

BACKGROUND: The recent use of spiral computed tomography (CT) without contrast for the diagnosis of acute flank pain has been shown to be highly sensitive and specific for the detection of urolithiasis. This method has not, however, been evaluated for its contribution to savings in management costs. The present study aims to evaluate the cost savings gained by instituting a protocol of early spiral CT to investigate these patients. METHODS: The records of 200 patients presenting to the Accident and Emergency Department (A&E) with acute flank pain during two periods were retrospectively reviewed. The first period was before the spiral CT protocol was instituted and the second was after. Cost analyses between the two periods were performed. RESULTS: After the spiral CT protocol, 72 versus 31 patients had a definitive diagnosis prior to discharge from hospital. The time taken to diagnosis was also significantly shorter after the protocol implementation (6.3 vs. 16.8 h). This resulted in a shorter time spent in the A&E, and hence bed cost savings. Radiological costs were reduced by 22%, but the major cost saving was made by a reduction in time spent in A&E (44%). CONCLUSIONS: The implementation of a protocol of early spiral CT for patients with suspected renal colic has led to earlier definitive diagnosis and shorter hospital stays. This is associated with a significant reduction in costs associated with managing this condition.

Non-deflation of Foley catheter balloon: use of transrectal ultrasound.

The problem of failed balloon deflation on removal of a Foley catheter is frequently observed. The use is reported of transrectal ultrasound with a small gauge biopsy needle to enable balloon deflation after the failure of less invasive techniques.

[Renal cancer today - suspicion, diagnosis or therapy? (author's transl)]. / Der Nierenkrebs in heutiger Sicht- ein Problem der Verdachterhebung, Diagnostik oder Therapie

The present-day situation of recording and diagnosis of malignant renal tumours was investigated on 50 patients recently seen by us. It was found that the complex radiological diagnosis (composed of excretion urography, isotope nephrography, renoscintigraphy, renovasography and additional investigations) is very well suited to show renal cancer in all stages taking into consideration localisation, extent and relations to surrounding tissue. As ever, the difficulty for a clarifying diagnosis still lies in seeing the patient as early as possible. This is due to the almost exclusively uncharacteristic symptoms which, additionally, very frequently coincide with symptoms of other diseases. The only chief symptom is clearly 'painless haematuria'. Relatively large renal tumours also escape palpation. The possibility of tracing haematurias during screening tests with 'Reagnost haemoglobin' tablets is discussed.

[Tumour frequency in autopsy cases. II. The malignant tumours of the stomach (author's transl)]. / Die Häufigkeit der Tumoren im Obduktionsgut. II. Mitteilung: Die malignen Magentumoren

The analysis is based on the catalogue of neoplasms notifiable in the German Democratic Republic (ICD-Code Nrs. 140--209, 210.2, 211.3, 211.9, 225, 226.2, 226.3, 253.0, 253.2, 702, 757.2). At the Medical Academy of Erfurt 22255 autopsies (12212 males, 9943 females) of adults (15 years and upwards) were registrated in the period from 1950 to 1966. 1153 malignant tumors of the stomach (15.5% of autopsies and 5.2% of all tumors) were observed. The cases are distributed among 1129 epithelial and 24 mesenchymal malignant tumors. Malignant epithelial tumours of the stomach were observed in 1129 cases (5.1% of autopsies and 75.2% of all tumours); 713 males and 416 females. The frequency difference is distinct. Malignant mesenchymal tumours of the stomach were observed in 24 cases (0.1% of autopies and 0.3% of all tumours); 14 males and 10 females. Their is no difference in frequency. Age distribution, sex distribution, frequency and localization of metastases are presented. At least the agreement of clinical diagnoses and pathological findings is discussed.