Adenocarcinoma of the prostate: innovations in management.

Adenocarcinoma of the prostate (CaP) in the Western world has become the most common noncutaneous human tumor. CaP is also the second most important cause of cancer deaths among the male population in the United States. Major progress was made in the past decade in better understanding this disease process, as well as in improved diagnostic accuracy. This improved diagnostic accuracy was due to wide application of prostate-specific antigen (PSA), use of transrectal ultrasound (TRUS), and greater awareness among clinicians of CaP. The use of PSA in clinical practice has resulted in a sharp increase in the number of patients diagnosed with capsule-confined tumors. The optimal treatment for capsule-confined CaP is in the process of being defined. Radical prostatectomy in the United States is currently the most commonly applied treatment for younger patients. Excellent treatment results with a 10-year actuarial survival > 80% are readily obtainable in properly selected patients. Nerve-sparing procedures helped reduce the high incidence of impotence that occurs in patients after radical retropubic prostatectomy. Radiotherapy remains the other curative treatment method in the management of CaP patients, with long-term survival rates similar to those reported in surgical series. Due to the problem of frequent preoperative tumor understaging, a routine use of postoperative irradiation to the prostatic fossa produces an excellent (> 95%) incidence of local tumor control. Management of patients with metastatic disease has undergone a considerable evolution with the development of modern hormonal management and treatment with strontium-89 to control intractable bone pain. Newer treatment methods such as hyperthermia are currently being investigated. Major efforts are directed toward the reduction of short- and long-term treatment toxicity associated with surgery, radiotherapy, and hormonal management, thus improving patient quality of life.

Stiffness changes in thermodynamic Nitinol with increasing temperature.

The purpose of this study was to measure and describe the physical properties of a recently-developed thermodynamic Nitinol alloy, type A-138, at intervals of temperature between room and body temperatures. The properties of stiffness, flexure yield strength and permanent deformation were measured, demonstrating that the working range of Nitinol A-138 is directly related to increases in temperature between 75 degrees F and 100 degrees F. As stiffness of the .017'' round A-138 Nitinol wire increases, the yield point decreases. In the loading cycle, yield points dropped from 36 degrees angular deflection at 75 degrees F to 25 degrees at 100 degrees F. In the unloading cycle, the yield point at 75 degrees F was 41 degrees of deflection, with force dropping to zero at 35 degrees; at 100 degrees F, yield point was only 12 degrees and force did not drop to zero until unloaded to 3 degrees angular deflection.