Patterns of relapse following radiotherapy for stage I seminoma of the testis: implications for follow-up.

A retrospective review was undertaken of 409 consecutive patients treated with adjuvant radiotherapy for Stage I seminoma between 1988 and 1997. A total of 339 men were treated to a volume encompassing the para-aortic nodes and 70 were treated with extended field radiotherapy. The patients were followed up within oncology clinics adhering to a standard protocol of clinical examination, chest radiography and measurement of serum marker levels. No routine computed tomographic (CT) scans were carried out. At a median follow-up of 57 months, 13 patients have relapsed, giving a recurrence-free rate of 97.2% at 3 years and 96.8% at 5 years. Of these, eight (62%) were detected at routine appointments and five (38%) requested early appointments. Chest radiography (2/5) and serum marker levels (3/5) identified disease in asymptomatic patients. Eight patients (62%) had raised markers at relapse, including two with normal serum markers at original presentation. The median size of pelvic node recurrences in the para-aortic-treated group was 7.3 cm (2.8-13 cm). Four patients have developed second testicular primaries: three were detected at routine appointments and one patient had requested an early appointment. We conclude that regular follow-up with serum marker estimations and chest radiography is sufficient to detect recurrence at an early stage and that our policy of no routine CT scanning has been shown to give acceptable results.

What is the nature of increased Stroop interference in schizophrenia?

In comparison to controls, patients with schizophrenia classically display (1) an overall slowing in response times (RTs) and (2) a disproportionate slowing in RTs in the conflict condition of the Stroop color/word interference task. These two effects appear repeatedly in the card version of the Stroop task but were not replicated in a number of studies using a computer item-by-item version of the task. The present study was aimed at understanding the exact nature of the increased interference classically found in the performance of patients with schizophrenia in the card version of the Stroop task. We used a computer trial-by-trial version in which we investigated the effects of two major methodological differences between the two versions: (1) blocked (card version) versus mixed (computer version) presentation of the neutral, congruent and conflict conditions and (2) presence (card version) versus absence (computer version) of distractors in the spatial surrounding of the target. We found an overall slowing in performance and a disproportionate slowing in the conflict condition for patients with schizophrenia but only when the target was surrounded by distractors (in Experiments 2 and 3). The data are discussed in terms of a deficit in selective attention and inhibitory processes in schizophrenia.

Bilateral ECT and autobiographical memory of subjective experiences related to melancholia: a pilot study.

The aim of this pilot study was to systematically assess the influence of bilateral, sine wave ECT on autobiographical memory of past subjective experiences related to melancholia. Twenty-one inpatients who met DSM-III-R criteria for a Major Depressive Episode, Melancholic Type, were included in the study. Twelve patients were treated by ECT (12 treatments), antidepressants and benzodiazepines; the comparison group comprised 9 patients treated by antidepressants and benzodiazepines. The Structured Interview Guide for the HDRS (SIGH-D) was used at admission and after the ECT treatment to standardize data collection about subjective experiences related to the depressive episode. Memory of subjective experiences related to melancholia was assessed with free-recall, cued-recall and recognition tasks. In addition, a free recall of events of the day on which the patients came to the hospital for their treatment was administered. These tasks were administered 1 week after the last treatment in the ECT-treated group and 4 to 6 weeks after the beginning of the treatment in the comparison group. Free-recall, cued-recall and recognition performances were significantly lower in the ECT-treated group than in the comparison group. No significant correlation was found between memory of events related to hospital admission and memory of subjective experiences related to depression. In conclusion, bilateral, sine wave ECT impairs autobiographical memory of subjective experiences related to melancholia in subjects tested 1 week after completion of a course of ECT.