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Summary Previous data indicate that receiving adequate information about their cancer can assist patients to cope with treatment and comply with treatment regimes. The aim of the present study was to determine whether time since diagnosis affected patients’ evaluations of the information they had received at the time of their diagnosis. Two hundred and thirty-seven patients who had received a diagnosis and treatment for prostate cancer 4 months earlier completed a questionnaire about their ratings of, and preferences for, various types of information, their anxiety and depression levels and some background data. The most common and preferred form of information that the patients in the current study received was verbal information during an interview with their oncologist. Demographic factors and levels of anxiety and depression did not influence patient information preferences. Time since diagnosis was associated with elevated anxiety and depression, and consequent lower recall of having received information, but also with positive inflation of the value of the material that they did recall having received. Patients may not recall information given to them early after diagnosis and may make unreliable evaluations of its value to them due to psychological state.

A core-shell-type polyion complex (PIC) micelle with a disulfide cross-linked core was prepared through the assembly of iminothiolane-modified poly(ethylene glycol)-block-poly(L-lysine) [PEG-b-(PLL-IM)] and siRNA at a characteristic optimum mixing ratio. The PIC micelles showed a spherical shape of approximately 60 nm in diameter with a narrow distribution. The micellar structure was maintained at physiological ionic strength but was disrupted under reductive conditions because of the cleavage of disulfide cross-links, which is desirable for siRNA release in the intracellular reductive environment. Importantly, environment-responsive PIC micelles achieved 100-fold higher siRNA transfection efficacy compared with non-cross-linked PICs prepared from PEG-b-poly(L-lysine), which were not stable at physiological ionic strength. PICs formed with PEG-b-(PLL-IM) at nonoptimum ratios did not assemble into micellar structure and did not achieve gene silencing following siRNA transfection. These findings show the feasibility of core cross-linked PIC micelles as carriers for therapeutic siRNA and show that stable micellar structure is critical for effective siRNA delivery into target cells.

Atomic coordinate analysis allows materials with appropriate but previously unrecognized dielectric properties to be predicted as new ferroelectrics if their crystal structure is known. An earlier such prediction that NaSb3F10is ferroelectric is confirmed herein without ambiguity. Its spontaneous polarizationPsis found to exhibit reproducible dielectric hysteresis at room temperature, withPs≃ 60 µC m−2, under the application of a field of 0.3 MV m−1or greater. The pyroelectric coefficient 〈p〉 = 17 (5) µC m−2 K−1at 298 K. NaSb3F10undergoes a phase transition atTC≃ 461 K, on correction for thermal hysteresis, with entropy change ΔS= 5.7 (3) J mol−1 K−1. The colorless crystals melt atTm ≃ 515 K and decompose above ∼600 K. The thermal hysteresis of ∼35 K inTC, on heating and cooling at 5–25 K min−1, is typical of first-order phase transitions. The space group in ferroelectric phase III isP63, and that in phase II is predicted to beP6322, a nonpolar supergroup ofP63; the supergroup expected in the prototypic nonferroic phase I isP63/mmc. The space group of phase III isnota direct subgroup of phase I. The dielectric permittivity ∊′ at 1 kHz increases over an order of magnitude between 300 K and a major inflection atTC, continuing to increase steadily thereafter toTm.

A multistate empirical valence bond (MSEVB) model for protonated water clusters, which incorporates the TIP4P water model, is presented. This model which is designated MSEVB4P represents a significant improvement over the original model of Voth et al. (J. Phys. Chem. B 1998, 102, 5547) which was based on the TIP3P water model and a smaller improvement over the recently introduced MSEVB3 model (J. Phys. Chem. B 2008, 112, 467) which is based on the SPC/Fw (J. Chem. Phys. 2006, 124, 024503) water model.

The objective of this systematic review was to identify quality trials that use sham radiotherapy in their design and review them to determine its potential value. The Cochrane Library, Pubmed and a Reference Search served as data sources. Trials were included if they met a minimum quality score of 3 on a validated assessment instrument (which assesses randomization, control and blinding) and if they compared sham radiotherapy to active treatment. External beam therapy and brachytherapy trials were considered. Twenty-six trials were identified, collectively including 2663 participants in the period of 1970-2004. All the trials studied the value of radiotherapy for treatment or prevention of benign diseases, including multiple sclerosis, coronary artery restenosis, age-related macular degeneration and Graves' ophthalmopathy. There were no trials relating to the use of radiotherapy in the treatment of malignancy. This review showed that it is possible to carry out sham radiotherapy with due regard for ethical concerns, with effective blinding and high levels of patient acceptance. Large sample sizes with multicentre trial designs were achievable. Although the statistical philosophy for using sham radiotherapy in trials is legitimate, it is no longer routinely used.

Si2H4 and Si7H8 cluster models are constructed for studying the role of high-order electron correlation effects on the buckling of SiSi dimers on the Si(100) surface. CASPT3, multi-reference coupled-pair functional, and the diffusion Monte Carlo methods are used to examine whether correlation effects not recovered in CASPT2 calculations are important for the buckling of the dimers. The calculations show that such high-order correlation effects are indeed important for determining the relative stability of the buckled and unbuckled structures.

To better identify prognostic factors for local control and survival, as well as the role of different therapeutic options, for phyllodes tumors, a rare fibroepithelial neoplasm of the breast.Data from 443 women treated between 1971 and 2003 were collected from the Rare Cancer Network. The median age was 40 years (range, 12-87 years). Tumors were benign in 284 cases (64%), borderline in 80 cases (18%), and malignant in 79 cases (18%). Surgery consisted of breast-conserving surgery (BCS) in 377 cases (85%) and total mastectomy (TM) in 66 cases (15%). Thirty-nine patients (9%) received adjuvant radiotherapy (RT).After a median follow-up of 106 months, local recurrence (LR) and distant metastases rates were 19% and 3.4%, respectively. In the malignant and borderline group (n = 159), RT significantly decreased LR (p = 0.02), and TM had better results than BCS (p = 0.0019). Multivariate analysis revealed benign histology, negative margins, and no residual disease (no RD) after initial treatment and RT delivery as independent favorable prognostic factors for local control; benign histology and low number of mitosis for disease-free survival; and pathologic tumor sizeor = 3 cm and no tumor necrosis for overall survival. In the malignant and borderline subgroup multivariate analysis TM was the only favorable independent prognostic factor for disease-free survival.This study showed that phyllodes tumor patients with no RD after treatment have better local control. Benign tumors have a good prognosis after surgery alone. In borderline and malignant tumors, TM had better results than BCS. Thus, in these forms adjuvant RT should be considered according to histologic criteria.

Background: Men with prostate cancer experience elevated levels of anxiety and depression, with some previous data suggesting that this is due to loss of previously-available social and personal reinforcing pleasant activities and abilities. Little is currently known about the range of activities/abilities that these patients lose, leaving open the question of how to best target lifestyle changes designed to help them overcome these negative effects on their mental health. This study used personal interviews to gather details of the pattern of lost activities/abilities from a sample of men with prostate cancer so that a self-report questionnaire might be developed for use in large-scale studies of the ‘causal map’ of anxiety and depression among these patients. Method: Ten men who had received a diagnosis of, and treatment for, prostate cancer during the previous 30 months were voluntary participants in a personal interview that tapped their experiences of the diagnostic and treatment processes a...

Summary Using a specially-constructed oven and sorbostats the sorption isosteres for microcrystalline cellulose have been obtained at temperatures between 25 and 90°C. Differences are shown between pre-drying at 105°C and pre-drying at the temperature of sorption. The sorption isosteres are not straight lines as expected.

SUMMARY Preferences for information about their disease and treatment were collected from 392 patients who had beentreated for either breast or prostate cancer an average of 2 years previously. Type of information that they hadreceived, their ratings of its value to them and their preferred format for further information were examined. Themost common and most preferred form of information was through doctor interview, followed by educationalbooklets. Prostate cancer patients preferred videotapes; breast cancer patients tended to prefer individualizedapproaches including a tour of the department. Effects of age, educational levels, occupational backgrounds andself-reports for anxiety and depression at the time of the survey and at time of diagnosis were analysed. Prostatecancer patients who were most severely depressed showed a preference for not receiving any information at all,perhaps reflecting a tendency towards withdrawal.Key words: breast; cancer; information; preference; prostate.

Background: The clinical significance of anxiety and depression in prostate cancer patients remains largely unclear. In particular, the importance of somatic symptoms and their change over time has been largely unaddressed in spite of their immediate relevance to an understanding of these psychosocial aspects of prostate cancer and its treatment. Methods: Self-reports of current and previous states of anxiety and depression were collected from 183 Australian men with prostate cancer between 9 and 71 months (average = 1 year 10 months) after initial diagnosis. An ‘Actual Change’ methodology was used to overcome the effects of extraneous sources of invalidity. Statistical tests of the total scores and specific item-changes over time were conducted. Results: Mean anxiety and depression levels reduced from time of diagnosis to time of the survey, with the most prominent changes being associated with reductions in psychomotor agitation, weakness, fatigue and pessimism. Clinically significant anxiety r...

The overall performance of coated products is determined by the intrinsic material properties in solution and processing conditions. To characterize the behavior of these materials, the viscosity of polymers in solution at various concentrations was measured and the experimental data were fitted with the Carreau model. The results describe the rheological behavior of coating materials, and provide a basis for the modeling of polymer flow during the coating process. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci, 2008

In an attempt to overcome the potential invalidity of response shift present in pre-test versus post-test designs, 197 breast cancer patients completed self-reports about their current anxiety and depression states about 2 years after diagnosis, and also for how they felt at the time of their diagnosis. Current and previous states of anxiety and depression, item analyses and factor analyses of these results, plus MANOVA across all items to test for changes over time (termed 'actual change' in the literature) were conducted. In addition, the combined anxiety and depression scores were analysed as a single unit to determine overlap of symptomatology and suggest possible treatments. As well as showing decreases in the proportion of participants who were experiencing clinically significant anxiety and depression from the time of diagnosis to the time of the survey, results indicated changes in the underlying anxiety symptomatology experienced by participants, moving from somatic complaints of fatigue to feelings of loss of control and inability to cope. The predominant symptomatology of depression remained consistently related to an inability to cope or make decisions, feelings of helplessness and loss. Suggestions for helping clinicians to deal with patients' symptomatology are discussed.

Zung's Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to collect data from 195 Australian men who had received a diagnosis of prostate cancer. Analysis was via separate scales and also by combining both scales into a single unit to assess anxiety–depression and then analysing the underlying component structure of that unit. Applying Zung's recommended cutoff scores, 12% of the sample were classified as having clinically significant levels of anxiety and 16% had similar levels of depression. Factor analysis of the combined SAS and SDS indicated four major components which reflected a process of: loss of functional capacity, worthlessness and hopelessness, fear and somatic symptomatology. Implications for the effective assessment and treatment of anxiety and depression in prostate patients are discussed. Copyright © 2006 John Wiley & Sons, Ltd.

Human papillomavirus (HPV) E6 and E7 oncogenes are essential for the immortalization and maintenance of HPV-associated cancer and are ubiquitously expressed in cervical cancer lesions. Small interfering RNA (siRNA) coding for E6 and E7 oncogenes is a promising approach for precise treatment of cervical cancer, yet a delivery system is required for systemic delivery to solid tumors. Here, an actively targeted polyion complex (PIC) micelle was applied to deliver siRNAs coding for HPV E6/E7 to HPV cervical cancer cell tumors in immune-incompetent tumor-bearing mice. A cell viability assay revealed that both HPV type 16 and 18 E6/E7 siRNAs (si16E6/E7 and si18E6/E7, respectively) interfered with proliferation of cervical cancer cell lines in an HPV type-specific manner. A fluorescence imaging biodistribution analysis further revealed that fluorescence dye-labeled siRNA-loaded PIC micelles efficiently accumulated within the tumor mass after systemic administration. Ultimately, intravenous injection of si16E6/E7 and si18E6/E7-loaded PIC micelles was found to significantly suppress the growth of subcutaneous SiHa and HeLa tumors, respectively. The specific activity of siRNA treatment was confirmed by the observation that p53 protein expression was restored in the tumors excised from the mice treated with si16E6/E7- and si18E6/E7-loaded PIC micelles for SiHa and HeLa tumors, respectively. Therefore, the actively targeted PIC micelle incorporating HPV E6/E7-coding siRNAs demonstrated its therapeutic potential against HPV-associated cancer.

The aim of this study was to investigate the effects of hormone therapy (HT) on depression and depressive symptoms in prostate cancer patients undergoing 6 months of HT.One hundred two prostate cancer patients who had been prescribed HT completed the Zung Self-rating Depression Scale (SDS) and two questions about their sexual enjoyment and performance, plus a background questionnaire before HT, after 8 to 10 weeks of HT and again after 16 to 20 weeks of HT.There was a significant increase in SDS scores from before to during HT. High depression score before HT was a significant predictor of later increases in depression during HT. Increases in depressive symptoms were restricted to 8 of the 20 SDS symptoms, the most powerful change being in sexual anhedonia, which was a result of decreased ability to perform during sexual activity.The association between HT and elevated depression is confirmed, but the relative influence of sexual anhedonia over other depressive symptoms expands the understanding of this association. The effects of decreased ability to perform during sex appear to dominate the increase in depression during HT. Copyright © 2016 John WileySons, Ltd.

In 2014 a consensus conference convened by the International Society of Urological Pathology (ISUP) adopted amendments to the criteria for Gleason grading and scoring (GS) for prostatic adenocarcinoma. The meeting defined a modified grading system based on 5 grading categories (grade 1, GS 3+3; grade 2, GS 3+4; grade 3, GS 4+3; grade 4, GS 8; grade 5, GS 9-10). In this study we have evaluated the prognostic significance of ISUP grading in 496 patients enrolled in the TROG 03.04 RADAR Trial. There were 19 grade 1, 118 grade 2, 193 grade 3, 88 grade 4 and 79 grade 5 tumours in the series, with follow-up for a minimum of 6.5 years. On follow-up 76 patients experienced distant progression of disease, 171 prostate specific antigen (PSA) progression and 39 prostate cancer deaths. In contrast to the 2005 modified Gleason system (MGS), the hazards of the distant and PSA progression endpoints, relative to grade 2, were significantly greater for grades 3, 4 and 5 of the 2014 ISUP grading scheme. Comparison of predictive ability utilising Harrell's concordance index, showed 2014 ISUP grading to significantly out-perform 2005 MGS grading for each of the three clinical endpoints.

(2006). Annual Report for 2005. Transactions of the Royal Society of South Africa: Vol. 61, No. 1, pp. 21-29.

ObjectiveTo describe the fate of perforator veins after surgical treatment of varicose veins and factors that influence this.MethodsThis prospective study of 104 patients assessed perforator veins by using duplex ultrasound scanning in 145 limbs before superficial vein surgery for varicose veins. Veins were marked preoperatively with ultrasound guidance and ligated with an open procedure; those missed were later treated with sclerotherapy. Duplex ultrasound scans and air plethysmography were used to confirm surgical success within 1 month and to monitor recurrence at 6 months, 1 year, and 3 years.ResultsA total of 850 incompetent perforators were treated, but 5.7% were missed and required further ablation. After 3 years, 75.8% of the limbs had developed further incompetent perforators for a total of 380 incompetent perforators. The number of ultrasound-detectable competent perforators had also increased from 356 to 1047 in that time. The incompetent perforators arose by (1) new vessel formation at the site of previous ligation in 152 (40.4%), (2) changes in pre-existing perforator vessels at other sites in 225 (59.2%), and (3) vessels missed at treatment (

Androgen deprivation is an established treatment regimen for disseminated prostate cancer; however, its role in patients with localised cancer is less clear. We did a large randomised controlled trial to determine whether 3 months or 6 months of androgen deprivation given before and during radiotherapy improves outcomes for patients with locally advanced prostate cancer.818 men with locally advanced prostate cancer were randomly assigned to: no androgen deprivation (ie, radiotherapy alone: 66 Gy in 33 fractions of 2 Gy per day over 6.5-7.0 weeks to the prostate and seminal vesicles); 3 months' androgen deprivation with 3.6 mg goserelin given subcutaneously every month and 250 mg flutamide given orally three times a day starting 2 months before radiotherapy (same regimen as control group); or 6 months' androgen deprivation, with the same regimen, starting 5 months before radiotherapy (same regimen as control group). Primary endpoints were time to local failure and prostate-cancer-specific survival; secondary endpoints were distant failure, disease-free survival, and freedom from salvage treatment. Analyses were done by intention to treat.802 (98%) patients were eligible for analysis. Median follow-up was 5.9 years (range 0.1-8.5). Compared with patients assigned no androgen deprivation, those assigned 3 months' treatment had significantly improved local failure (hazard ratio [HR] 0.56 [95% CI 0.39-0.79], p=0.001), biochemical failure-free survival (0.70 [0.56-0.88], p=0.002), disease-free survival (0.65 [0.52-0.80], p=0.0001), and freedom from salvage treatment (0.73 [0.56-0.96], p=0.025). 6 months' androgen deprivation significantly improved local failure (0.42 [0.28-0.62], p0.0001), biochemical failure-free survival (0.58 [0.46-0.74], p0.0001), disease-free survival (0.56 [0.45-0.69], p0.0001), freedom from salvage treatment (0.53 [0.40-0.71], p0.0001), distant failure (0.67 [0.45-0.99], p=0.046) and prostate-cancer-specific survival (0.56 [0.32-0.98], p=0.04) compared with no androgen deprivation.6 months' androgen deprivation given before and during radiotherapy improves the outlook of patients with locally advanced prostate cancer. Further follow-up is needed to estimate precisely the size of survival benefits. Increased radiation doses and additional periods of androgen deprivation might lead to further benefit.

BACKGROUMD. The curative potential of radiotherapy CRT) alone as initial treatment for patients with Stage I-II lymphocyte-predominant Hodgkin lymphoma (LPHL) has not been defined well. METHODS. Two hundred two patients who were treated between 1969 and 1995 were evaluated in a retrospective, multicenter study. RESULTS. Patient characteristics were as follows: The median age was 31 years, 75% of patients were male, 80% of patients had Ann Arbor Stage I disease, 1% of patients had bulky disease, 3% of patients had B symptoms, 1% of patients had extranodal involvement, and 80% of patients had supradiaphragmatic disease. The RT fields were a full mantle field in 52% of patients, less than a full mantle field in 24% of patients, an inverted-Y field in 17% of patients, less than an inverted-Y field in 3% of patients, and total lymph node irradiation in 3% of patients. The median dose was 36 Gray. The median follow-up was 15 years. The overall survival (OS) rate at 15 years was 83%, and freedom from progression (FFP) was observed in 82% of patients, including 84% of patients with Stage I disease and 73% of patients with Stage II disease. No recurrent LPHL and only 1 patient with non-Hodgkin lymphoma (NHL) were reported after 15 years. Adverse prognostic factors that were identified on multifactor analysis were as follows: for OS, age 45 years or older (P < 0.0005), the presence of B symptoms (P = 0.002), increasing number of sites (P = 0.015); for FFP, increasing number of sites (P= 0.002). No significant difference was found in FFP in a comparison of patients who received elective mediastinal RT with patients who did not receive mediastinal RT (P = 0.11). Causes of death at 15 years were LPHL in 3% of patients, NHL in 2% of patients, in-field malignancy in 2% of patients, in-field cardiac/respiratory in 4% of patients, and other in 6% of patients. CONCLUSIONS. The current data suggested that RT potentially may be curative for patients with Stage I-II LPHL and raise the possibility that limited-field RT may be used without loss of treatment efficacy. Involved-field RT warrants further inves-tigation for patients with early-stage LPHL.

Aims To determine how the accuracy of a photographic system for cosmetic assessment of the breast after conserving treatment can be maximised. Materials and methods Photographs of 40 women undergoing breast-conserving treatment for breast cancer were taken. Upward and lateral retraction was measured using a digitiser to enter the locations of reference marks on the photographs into a computer programme. In the readings produced, reduction in three potential sources of variation was considered by determining how few repeated photographs or measures were necessary to achieve an estimate within ±2 mm of a mean value obtained from a large series. These included variation between assessments of the same photograph, between different photographs of the same patient and between different observers. We also sought to determine whether the attachment of white nipple markers (WNM) at the time of photography would reduce variation. Results A minimum of five readings was required from each photograph in order to obtain a result that was stable (defined as within 1 mm of that achieved by 20 readings). Using similar criteria, we found that at least four photographs of each patient were required, and that each should be assessed by at least four observers. The addition of WNM reduced the standard deviations by 36–45%. Conclusion The use of WNM, which is simple, quick and cheap, is effective in reducing variation and can be recommended for use in clinical trials where overhead costs need to be contained.

Background Varicose vein surgery is generally considered to have little risk of postoperative deep vein thrombosis (DVT). This prospective study examined the incidence of DVT in patients undergoing varicose vein surgery. Methods Lower leg veins were assessed before operation by duplex ultrasonography in 377 patients, and reassessed 2–4 weeks after surgery, and again at 6 and 12 months. Patients were instructed to contact a physician if symptoms consistent with DVT occurred before the scheduled follow-up appointment. Preoperative prophylaxis (a single dose of subcutaneous heparin) was left to the discretion of the vascular surgeon. Results DVT was detected in 20 (5·3 per cent) of the 377 patients. Of these, only eight were symptomatic and no patient developed symptoms consistent with pulmonary embolus. Eighteen of the 20 DVTs were confined to the calf veins. Subcutaneous heparin did not alter the outcome. No propagation of thrombus was observed and half of the DVTs had resolved without deep venous reflux at 1 year. Conclusion The incidence of DVT following varicose vein surgery was higher than previously thought, but these DVTs had minimal short- or long-term clinical significance.

Summary The use of radiotherapy for plantar fasciitis has never been reported in Australasia and is scarcely found in the English language medical literature, but it is commonly used in Europe, especially in Germany. In Europe, treatment courses consisting of multiple small fractions have been associated with high levels of pain relief. In the present report, the use of single fractions or radiotherapy was evaluated by reviewing seven consecutive patients referred for treatment and by applying objective and subjective criteria for pain relief. One patient died of unrelated causes soon after treatment and one declined to receive radiotherapy. Four patients each received a single dose of 8 Gy resulting in complete pain relief. One patient was treated with 8 Gy and 12 weeks later was retreated achieving partial pain relief. A follow-up interview was conducted after a mean of 15.6 months, ranging from 1.5 to 30 months. No acute or late effects occurred; however, the possibility that delayed effects may yet occur, particularly carcinogenesis, cannot be excluded. Radiotherapy for this common condition should be investigated further as it might be safer and more effective than other methods currently in use.

Objective We observed long-term venous ultrasound and plethysmographic changes after varicose vein surgery, to determine factors that influence recurrence. Methods and materials This observational sequential prospective study was carried out in an institutional referral center with day surgery. Subjects were 92 consecutive patients, ages 20 to 75 years, with symptomatic varicose veins in 127 limbs, who were able to complete regular assessment. Superficial varicose vein surgery included significant perforator vessels only, defined at preoperative duplex ultrasound scanning and air plethysmography. Similar follow-up assessments were performed at 3 weeks, 3 months, and 1, 3, and 5 years. Results At 3 weeks venous reflux but not muscle pump function was consistently improved in all limbs. However, inadequate surgery at the major junctions was clearly identified as contributing to recurrence of disease in 7.2% of limbs. Recurrence of varicose veins occurred in 1 of 100 limbs (1%) at the saphenofemoral junction and in 8 of 33 (25%) limbs at the saphenopopliteal junction. However, after 3 years disease recurrence at these sites had increased to 23% and 52%, respectively. Incompetent perforator vessels increased progressively in number. Clinical recurrence was 47.1%, and consistent with this was gradual deterioration in air plethysmographic measures of reflux, with physiologic recurrence (venous filling index, >2 mL/s) in 66% at 5 years. Late recurrence was predicted in limbs with multiple sites of reflux preoperatively, venous filling index greater than 2 mL/s, and some other persistent abnormality at duplex scanning at 3 weeks. There was no recurrence in 40 limbs in which these factors were normal at at 3 weeks. However, 29 of 53 limbs with normal venous filling index after operative intervention had deteriorated at 3 years. Conclusion Incomplete superficial surgery, in particular at the saphenofemoral and saphenopopliteal junctions, is a less frequent cause of recurrent disease, and neovascular reconnection and persistent abnormal venous function are the major contributors to disease recurrence.

The purpose of this study was to prospectively examine the effectiveness and tolerability of a simple radiotherapy technique for the palliation of symptomatic liver metastases. Twenty-eight patients with symptomatic liver metastases were enrolled from seven centres, and received targeted (partial or whole) liver irradiation consisting of 10 Gy in two fractions over 2 days. Symptoms at baseline were hepatic pain (27 patients), abdominal distension (19), night sweats (12), nausea (18) and vomiting (eight). Twenty-two patients (76%) had failed previous treatment with chemotherapy, hormonal therapy and/or high-dose steroids. Symptoms and potential toxicities were prospectively assessed at the time of treatment, then 2, 6 and 10 weeks later. Individual symptom response rates were 53-66% at 2 weeks. Partial or complete global symptomatic responses were noted in 15 patients (54%) overall. The treatment was well tolerated with two patients (7%) experiencing grade 3 toxicity (one vomiting and one diarrhoea); however, four patients reported temporary worsening of pain shortly after treatment. This simple and well-tolerated treatment achieves useful palliation.

The finite temperature behavior of H+(H2O)6 and H+(H2O)8 is investigated by means of parallel tempering Monte Carlo simulations in conjunction with the multistate empirical valence-bond method for describing the interactions. The temperature dependence of the constant volume configurational heat capacity, CV(T), of H+(H2O)8 reveals two sharp transitions, whereas that of H+(H2O)6 is devoid of sharp structure.

To measure the prevalence and severity of Generalised Anxiety Disorder (GAD), hypo- and hypercortisolaemia, and their association in a sample of prostate cancer (PCa) patients, 97 Australian PCa patients completed a background questionnaire and the GAD-7, and provided a sample of saliva collected 30-45 min after waking. The mean GAD7 score was 9.67 (SD = 3.09), and prevalence rates for current anxiety were higher than those reported for non-PCa males of a similar age. Mean salivary cortisol concentrations (30.78 nmol/L, SD = 13.97 nmol/L) were also higher than for age-comparative non-PCa men. There was a significant inverse correlation between GAD and cortisol (r = -. 209, p < .05), and four subgroups of GAD-cortisol patients were able to be identified, with evidence of both hyper- and hypocortisolaemia. These findings provide initial neurobiological evidence of the chronic and profound nature of stress experienced by PCa patients, and also suggest a possible measure that might be used to identify most at-risk PCa patients.

The aim of this study was to review regret following treatment for localized prostate cancer, including factors associated with higher levels of regret, regret after specific treatments and the use of interventions to modify the likelihood of regret.Online databases including Medline, CINAHL, EMBASE, EBSCO and PsycINFO were searched in June 2014, using the terms 'prostate' and 'regret' for publications written in English and appearing in print since the year 1997.Of 422 articles identified by the search criteria, 28 contained analyzable data regarding 8118 patients. The most commonly identified factors associated with regret after prostate cancer treatment were treatment toxicity factors, especially sexual and urinary function. Other factors included older age and longer time since treatment. The levels of regret were generally higher after radical prostatectomy than external beam radiotherapy or brachytherapy. Decision-making aids were the most commonly used method for reducing the likelihood of regret and were effective.This is the first systematic review of regret following treatment for localized prostate cancer. Suggestions for the future study of regret in this setting can be made. These include the use of a standardized scale; recognizing levels of regret as low, medium or high; and separately identifying the decision made when patients have combinations of treatments such as surgery followed by radiotherapy.

For small interfering RNA (siRNA)-based cancer therapies, we report an actively-targeted and stabilized polyion complex micelle designed to improve tumor accumulation and cancer cell uptake of siRNA following systemic administration. Improvement in micelle stability was achieved using two stabilization mechanisms; covalent disulfide cross-linking and non-covalent hydrophobic interactions. The polymer component was designed to provide disulfide cross-linking and cancer cell-targeting cyclic RGD peptide ligands, while cholesterol-modified siRNA (Chol-siRNA) provided additional hydrophobic stabilization to the micelle structure. Dynamic light scattering confirmed formation of nano-sized disulfide cross-linked micelles (

The low-lying minima on the Born−Oppenheimer potential energy surface of the H3O+(H2O)4 cluster are investigated by effective valence bond (EVB), density functional, and MP2 methods. Although Becke3LYP and MP2 calculations predict the same global minimum structure, the relative energies of various structures obtained by these two approaches differ by up to 1.7 kcal/mol. Even larger differences are found between the relative energies calculated at the EVB and MP2 levels of theory. Vibrational spectra are calculated for each of the minimum energy species.

In Alzheimer's disease, amyloid-beta peptide aggregates in the extracellular space to form senile plaques. The process of plaque deposition and growth has been modeled on the basis of in vitro experiments in ways that lead to divergent predictions: either a diffusion-limited growth model in which plaques grow by first-order kinetics, or a dynamic model of continual deposition and asymmetrical clearance in which plaques reach a stable size and stop growing but evolve morphologically over time. The models have not been tested in vivo because plaques are too small (by several orders of magnitude) for conventional imaging modalities. We now report in vivo multiphoton laser scanning imaging of thioflavine S-stained senile plaques in the Tg2576 transgenic mouse model of Alzheimer's disease to test these biophysical models and show that there is no detectable change in plaque size over extended periods of time. Qualitatively, geometric features remain unchanged over time in the vast majority of the 349 plaques imaged and re-imaged. Intervals as long as 5 months were obtained. Nonetheless, rare examples of growth or shrinkage of individual plaques do occur, and new plaques appear between imaging sessions. These results indicate that thioflavine S-positive plaques appear and then are stable, supporting a dynamic feedback model of plaque growth.

Analysis of the atomic arrangement in anhydrous aminoguanidinium hexafluorozirconate, CN4H8ZrF6, reported by Bukvetskii, Gerasimenko & Davidovich [Koord. Khim.(1990),16, 1479–1484], led to the prediction that it is a new ferroelectric [Abrahams, Mirsky & Nielson (1996).Acta Cryst.B52, 806–809]. Initial attempts to verify the prediction were inconclusive because of the variety of closely related materials produced under the original preparation conditions. Clarification of these conditions led to the formation of pure CN4H8ZrF6and the growth of single crystals with dimensions as large as 7 × 7 × 2 mm. Highly reproducible calorimetric and dielectric permittivity anomalies reveal the Curie temperatureTc= 383 (1) K. At this temperature, the heat capacityCpexhibits an entropy change of 0.7 (1) J mol−1 K−1, while the relative permittivity ∊rexhibits an inflection and the dielectric loss a distinct peak; the dielectric anomaly atTcis observed only at the lowest (0.1–1 kHz) frequencies used. Dielectric hysteresis is demonstrable at 295 K under the application of ∼1 MV m−1alternating fields and remains observable at allT

Objective The aim of this study is to explore the associations between hormone treatment variables and depression, and the nature of depression in prostate cancer (PCa) patients by comparing the severity and symptom profile of anxiety and depression in men who were currently receiving hormone therapy (HT) versus those who were not. Method Self-reports of anxiety and depression on standardized scales of GAD and major depressive disorder (MDD) were collected from 156 PCa patients across two recruitment sites in Australia. Patients who were currently receiving HT were compared with patients not receiving HT for their severity and symptom profiles on GAD and MDD. Results Participants receiving HT had significantly higher GAD and MDD total scores than patients who were not receiving HT. In addition, the symptom profiles of these two HT subgroups were differentiated by significantly higher scores on the key criteria for GAD and MDD plus fatigue and sleeping difficulties but not the remaining symptoms of GAD and MDD. However, there were no significant differences between HT subgroups for the degree of functional impairment experienced by these symptoms. Conclusion Although these data confirm the association between HT and anxiety/depression, the range of GAD and MDD symptoms influenced is relatively restricted. Moreover, functional ability does not appear to be impaired by HT. These findings clarify the ways in which HT affects PCa patients and suggests that a simple total scale score for anxiety and depression may not be as helpful in designing treatment as consideration of the symptomatic profiles of PCa patients receiving HT. Copyright © 2014 John Wiley & Sons, Ltd.

Indolent lymphomas primarily involving the skeleton (iPBL) represent1% of all primary bone lymphomas. The management and prognosis have not been previously described. Patients with primary and secondary iPBL were selected from an international database of 499 patients with a histopathological diagnosis of non-Hodgkin lymphoma and skeleton involvement, and clinical features, management and prognosis were analyzed. Twenty-six (5%) patients had an iPBL. Ten patients had small lymphocytic lymphoma, 10 had follicular lymphoma and six had lymphoplasmacytic lymphoma. Eleven patients had limited stage and 15 had advanced disease. The overall response rate was 73% (95% confidence interval [CI] = 57-89%). Median follow-up was 58 months, and the 5- and 10-year progression-free survival (PFS) rates were 37 ± 10% and 25 ± 12%, respectively. Nine patients are alive, with 5- and 10-year overall survival (OS) rates of 46 ± 10% and 29 ± 11%, respectively. Patients with small lymphocytic lymphoma showed significantly better outcome than patients with follicular lymphoma. Performance status and stage of disease were independently associated with OS. The prognosis of patients with primary bone lymphoplasmacytic or follicular lymphoma was less favorable.

Venous function measured by air-plethysmography (APG) was compared to anatomical patterns of reflux assessed by duplex scanning and associated clinical features in 253 limbs with recurrent varicose veins following previous superficial venous surgery. The results showed that a previous history of deep venous thrombosis, previous procedure with preservation of the long saphenous vein, and a history of healed ulcer or current ulcer were each associated with worse venous function. Patterns of reflux which included multiple sites of reflux and presence of deep incompetence were also associated with worse venous function. Where there was reflux in the groin, limbs with a wide recurrent saphenofemoral junction presented the worst venous filling time and venous filling index, whereas those with reflux unrelated to the common femoral vein had nearly normal venous physiology and occurred almost exclusively in females. The other patterns of recurrence in the groin were physiologically indistinguishable from each other. In conclusion, certain patterns of reflux, clinical and operative features are associated with worse venous physiology in limbs with recurrent varicose veins. These features of recurrence with more severe physiological disturbance may necessitate a higher priority for surgical intervention.

Three very different methods of accomplishing the same task-managing the operation of the transmission system in the deregulated power system operating environment-have been implemented as deregulated market structures have been created around the world. They are first, the optimal power flow (OPF) model found in various implementations in the United Kingdom, parts of the United States, and in Australia and New Zealand. Second, the point tariff, price area congestion control model used in the Nordpool market area in Norway and Sweden. Third, the US transaction-based model. All are pragmatic solutions implemented in advance of complete theoretical understanding. Each has strengths and flaws, and there are some surprising inter-relationships. Each maintains power system security but differs in its impact on the economics of the energy market. No clearly superior method has so far emerged. In the future, methods of combining decentralized market solutions with operational use of optimal power flow may provide better solutions to existing and emerging problems.

OBJECTIVE: To determine whether tight control of blood pressure prevents macrovascular and microvascular complications in patients with type 2 diabetes. DESIGN: Randomised controlled trial comparing tight control of blood pressure aiming at a blood pressure of

We investigated the role of neuronal (type I) nitric oxide synthase (nNOS) in NMDA-mediated excitotoxicity in wild-type (SV129 and C57BL/6J) and type I NOS knock-out (nNOS−/−) mice and examined its relationship to apoptosis. Excitotoxic lesions were produced by intrastriatal stereotactic NMDA microinjections (10–20 nmol). Lesion size was dose- and time-dependent, completely blocked by MK-801 pretreatment, and smaller in nNOS knock-out mice compared with wild-type littermates (nNOS+/+, 11.7 ± 1.7 mm3;n= 8; nNOS−/−, 6.4 ± 1.8 mm3;n= 7). The density and distribution of striatal NMDA binding sites, determined by NMDA receptor autoradiography, did not differ between strains. Pharmacological inhibition of nNOS by 7-nitroindazole (50 mg/kg, i.p.) decreased NMDA lesion size by 32% in wild-type mice (n= 7). Neurochemical and immunohistochemical measurements of brain nitrotyrosine, a product of peroxynitrite formation, were increased markedly in wild-type but not in the nNOS−/−mice. Moreover, elevations in 2,3- and 2,5-dihydroxybenzoic acid levels were significantly reduced in the mutant striatum, as a measure of hydroxyl radical production.The importance of apoptosis to NMDA receptor-mediated toxicity was evaluated by DNA laddering and by quantitative histochemistry [terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate–biotin nick end-labeling (TUNEL) staining]. DNA laddering was first detected within lesioned tissue after 12–24 hr. TUNEL-positive cells were first observed at 12 hr, increased in number at 48 hr and 7 d, and were located predominantly in proximity to the lesion border. The density was significantly lower in nNOS−/−mice. Hence, oligonucleosomal DNA breakdown suggesting apoptosis develops as a late consequence of NMDA microinjection and is reduced in nNOS mutants. The mechanism of protection in nNOS−/−mice may relate to decreased oxygen free radical production and related NO reaction products and, in part, involves mechanisms of neuronal death associated with the delayed appearance of apoptosis.

We quantitatively analyzed, using laser scanning confocal microscopy, the three-dimensional structure of individual senile plaques in Alzheimer disease. We carried out the quantitative analysis using statistical methods to gain insights about the processes that govern A β peptide deposition. Our results show that plaques are complex porous structures with characteristic pore sizes. We interpret plaque morphology in the context of a new dynamical model based on competing aggregation and disaggregation processes in kinetic steady-state equilibrium with an additional diffusion process allowing A β deposits to diffuse over the surface of plaques.

A family is presented in whom hereditary angioedema (HAE) and hereditary breast cancer were coexistent, an association not previously reported. A potential for genetic and treatment-related interactions between the two conditions exists. The use of the hormonal agent danazol to suppress HAE is unlikely to adversely affect the development or outcome of breast cancer. Surgery, chemotherapy, and radiotherapy were received by affected family members, without triggering edema. Whether hormonal breast cancer treatment affects the suppression of HAE by danazol remains unknown.

Five cases diagnosed as extraosseous Ewing's sarcoma (EES) during a 15-year period, and the relevant literature, were reviewed. The diagnosis in these cases was difficult to confirm, mainly because the distinction between the osseous form of Ewing's sarcoma (OES) and either periosteal reactions or direct tumour invasion into adjacent bone by EES was often unclear. The literature suggests that other authors have also encountered difficulties. The authors believe that many cases reported as EES are likely to have been OES. This distinction has some importance, as the two conditions are usually treated in differing ways. The following criteria are proposed for the diagnosis of primary EES: (i) no evidence of bony involvement on magnetic resonance imaging; (ii) no evidence of increased uptake in bone or periosteum adjacent to the tumour on static isotope bone scan images; (iii) a small round cell tumour with no differentiating features on light microscopy, immunochemistry or electron microscopy; and (iv) demonstration of cytoplasmic glycogen.

This study aims to develop and test three potential models of Individual Burden of Illness for Depression (IBI-D) in prostate cancer patients.Responses to three sets of scales measuring depressive symptoms, functional impairment, and quality of life satisfaction were collected from 191 prostate cancer patients and analysed via principal components analysis to obtain weightings for each of the scales within the three sets of measures. These weightings were then used to form IBI-D Indices, and these were then compared with depressive symptoms alone for their overlap.Single-factor solutions were found for each of the three IBI-D models, demonstrating generalizability across the three models. Equations based on the loadings of each scale within each IBI-D model, divided by the standard deviation of total IBI-D scores, were used to form IBI-D Indices. Although the correlations between the Patient Health Questionnaire-9 (PHQ9) and each of these IBI-D Indices were statistically significant, between one-quarter and one-fifth of the variance in IBI-D Indices was not accounted for by PHQ9 score alone, demonstrating that the IBI-D Indices provided additional information above that obtainable from a measure of depression alone.The IBI-D Index can be used to more completely assess the overall effects of depression in prostate cancer patients, the associations between those effects and predictor variables, and the outcomes of intervention studies aimed at decreasing depression (and its effects) in these men.