Ninety‐five malignant tumors in the submandibular gland, the sublingual gland, and the minor salivary glands seen in a 25‐year period were reviewed. The patients were retrospectively staged using the ...Union Internationale Contre le Cancer (UICC) classification. The most frequent tumor was adenoid cystic carcinoma, followed by adenocarcinoma. The submandibular gland was the most frequent location. Five‐year and 10‐year crude survival rates were 62% and 43%, respectively. Clinical stage was the most important prognostic factor. Survival was not correlated with location of tumor, although recurrence and metastases occurred more frequently in patients with cancer of the submandibular gland. Histologically, the 5‐year and 10‐year survival was significantly better for patients with adenoid cystic carcinoma compared with the other types; however, although still significant, this difference diminished at 10 years, confirming the need for a long observation time for patients with this tumor. 68:2424‐2431, 1991.
We used combined diffusion-weighted (DWI) and perfusion-weighted (PWI) MRI to characterize hyperacute infarctions within 6 h of symptom onset with special reference to subcortical infarctions, and ...investigated the relation between perfusion-diffusion mismatch volume and functional outcome.
Twenty-two patients presenting with symptoms of acute stroke underwent DWI and PWI within 6 h of symptom onset, and follow-up MRI 30 days later. Twelve of these had a subcortical infarction on acute DWI. Lesion volumes were measured by acute DWI and PWI as well as chronic T(2)-weighted MRI (T2WI). Clinical severity was measured by the Scandinavian Stroke Scale (SSS) and the Barthel Index (BI).
In the 12 patients with subcortical infarctions, PWI and especially DWI correlated strongly with acute and chronic neurological SSS score, as well as with final infarct volume. Furthermore, a hyperacute PWI/DWI mismatch in this subgroup predicted lesion growth. There was a weaker correlation between acute DWI/PWI and neurological score among all 22 patients, and patients with a PWI/DWI mismatch larger than 100 ml had a significantly larger lesion growth and a poorer outcome than patients with a smaller mismatch.
Subcortical infarctions may represent a sizeable subgroup of acute stroke patients. Also subcortical infarctions may have a PWI/DWI mismatch and therefore may respond to neuroprotective/thrombolytic therapy. Hyperacute DWI may reflect the acute clinical status and predict the outcome in patients with subcortical infarction.
A controlled study of the effect of treatment of recurrent urethral stricture by internal urethrotomy followed by clean intermittent self-catheterization for 3 months is reported. There were 28 men ...(median age 70 years, range 18 to 75) allocated to internal urethrotomy and clean intermittent self-catheterization for 3 months (treatment group) and 33 (median age 76 years, range 36 to 87) were randomized to undergo internal urethrotomy only (observation group). The groups were comparable in terms of patient age, etiology of the primary stricture, number of recurrences, length and site of the actual stricture, and preoperative maximum flow rate (p less than 0.01). After termination of the treatment all patients from both groups were evaluated by uroflowmetry 2, 4, 6 and 12 months later, and a new recurrence was defined as a maximum flow rate of less than 10 ml. per second (micturition volume greater than 100 ml.) and a characteristic flow curve. From the treatment group 23 patients could be assessed: 2 had discontinued clean intermittent self-catheterization due to urethral hemorrhage, 2 died during the observation period and 1 was lost to followup. From the observation group 28 patients were assessable: 3 died during the observation period and 1 was lost to followup. Treatment results were not significantly different (p less than 0.01). Of the patients in the treatment and observation groups 78% and 82%, respectively, had a new stricture. The median interval for this to occur was 4 months for both groups. Since no patient had clinical signs of stricture during clean intermittent self-catheterization, we conclude that for the treatment of recurrent urethral stricture clean intermittent self-catheterization following internal urethrotomy should be continued for a long duration, possibly permanently.
In a 16-month period the one-hour pad-weighing test proposed by the International Continence Society was used in 126 instances for objective assessment of the degree of incontinence in 81 women with ...urinary incontinence. The present study deals with applicability of the test, patient compliance, reproducibility of the test, and comparison of test results with conventional methods for objective assessment of urinary incontinence. In spite of a rather high mean age (55 years), 73 patients (88%) were able to perform the entire test program. In 85 tests (68%) the patients indicated the result to be in accordance with the daily leakage. The reproducibility of the test was relatively good (r = 0.68; P less than .01), but significantly better (r = 0.93; P less than .0001) when taking into consideration the bladder volume at test start and the diuresis during the test. When compared with the pad-weighing test, the stress test and voiding-cystourethrography gave false negative results in approximately half the cases. The one-hour pad-weighing test was found to be practical and useful in quantifying the degree of leakage in women with urinary incontinence.
The adrenolytic agent mitotane o,p'-DDD or 1,1-(o,p'-dichlorodiphenyl)-2, 2-dichloroethane has been employed in the nonsurgical treatment of patients with adrenal carcinoma for several decades. Its ...use is hampered by serious side effects, which may be limited by analytically guided dose modifications in the individual patient. Mitotane analyses have previously been undertaken by gas chromatography with electron capture detection. A sensitive high-pressure liquid chromatographic method for measuring mitotane in plasma is described. After protein precipitation with 1.5 vol of acetone, mitotane and its metabolite 1,1-(o,p'-dichlorodiphenyl)-2,2-dichloroethene (o,p'-DDE) are resolved by isocratic elution from a C18 reversed-phase support and quantified by ultraviolet detection at 230 nm. Recoveries of mitotane and o,p'-DDE after deproteinization were quantitative. Within-run and between-day coefficients of variation were < 4% over the entire therapeutic range. The limit of detection was 0.25 mumol/L and the standard curve was linear in the 1-100 mumol/L range. The method has been evaluated using samples obtained from an adolescent girl who had metastatic adrenocortical carcinoma. Data from this single patient may suggest that systemic absorption of mitotane is adequate, and toxicity possibly decreased, when mitotane is administered by the rectal route.
A single basic ribosomal protein, protein S7, can be multiply phosphorylated in the ciliated protozoan Tetrahymena. Induction of phosphorylation is highly regulated, and the phosphorylation proceeds ...in a strictly sequential manner. The first site to be phosphorylated is a serine residue and the second a threonine. In this paper we report the complete primary structure of Tetrahymena thermophila ribosomal protein S7 including identification of the phosphorylated serine and threonine residues. Most of the sequence information was obtained from peptides generated by in situ digestion of S7 in two-dimensional gels using an approach that combined traditional protein chemistry with mass spectrometry. T. thermophila ribosomal protein S7 has a molecular mass of 29,459 Da and contains 259 amino acid residues. Phosphorylation takes place on Ser258 and Thr248 in the C-terminal region of the protein. Alignment of T. thermophila ribosomal protein S7 with known ribosomal proteins yielded the surprising result that T. thermophila S7 is homologous, not with mammalian ribosomal protein S6, but with mammalian ribosomal protein S4. These findings clearly distinguish the pattern of phosphorylation of ribosomal proteins in Tetrahymena from all other eukaryotes analyzed to date.
We determined the circulating dopamine levels in 17 patients with insulin-dependent diabetes mellitus (IDDM), of whom eight had amenorrhoea (DM-AM) and nine were normally menstruating (DM). Seven ...non-diabetic women with normoprolactinaemic, normogonadotrophic secondary amenorrhoea (AM) and nine normally menstruating women (controls) were studied. In all subjects basal blood concentrations of free dopamine (f-DA), conjugated dopamine (c-DA), epinephrine (E), norepinephrine (NE), prolactin (PRL), luteinizing hormone (LH), thyroid-stimulating hormone (TSH) and oestradiol-17 beta were determined and all subjects, except for three AM patients, had a Metoclopramide test performed for measurements of f-DA, c-DA, PRL, LH and TSH. Plasma c-DA was significantly (p less than 0.05) increased in patients with amenorrhoea compared to the respective control groups. In diabetic patients c-DA levels were significantly (p less than 0.05) lower compared to controls. The ratio between basal f-DA and c-DA concentrations was significantly (p less than 0.01) higher in diabetic patients compared with non-diabetic patients. After Metoclopramide stimulation DM-AM patients showed a significant (p less than 0.05) rise in c-DA, whereas this was not seen in other groups. DM-AM patients had significantly (p less than 0.05) lower basal PRL and LH levels than DM patients and controls. In addition DM-AM patients had a significantly (p less than 0.05) lower PRL response to Metoclopramide compared with DM patients. There were no significant correlations between catecholamines and basal as well as Metoclopramide stimulated pituitary hormones. This study suggests that the abnormal pituitary hormone secretion in patients with amenorrhoea may in part be caused by an increased dopaminergic activity.
In a 10-year period, 15 patients were treated with bladder distension because of urinary symptoms associated with detrusor instability. All patients had failed to respond to previous drug therapy. ...Ten patients had previously undergone surgical procedures for urinary incontinence, also without success. Five patients had repeated bladder distensions performed because of lack of improvement after the first procedure. Follow-up cystometry was performed in 14 cases. In all cases the instability was unchanged. Only one patient reported improvement in voiding symptoms. No complications were seen. With a success-rate of 6% (1 out of 15 patients) we do not recommend bladder distension with the present procedure as therapy for detrusor instability.
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