LESS THAN Research Articles

INTERVAL AFTER PROSTATE SPECIFIC ANTIGEN TESTING AND SUBSEQUENT RISK OF INCURABLE PROSTATE CANCER

Studies of the potential effect of prostate specific antigen (PSA) screening on a less than yearly basis have been limited to computer simulations using relatively small sample sets. Primary clinical data on this relationship have not been generally available. We examined the relationship of less frequent testing and the risk of nonlocalized incurable cancer. The effect of testing frequency on the risk of prostate biopsy in men ultimately diagnosed with cancer was also assessed. The study included a population based sample of 36,422 men 65 years old or older residing in 9 geographic areas with newly diagnosed prostate cancer during 1989 to 1993. The primary end point was the risk of nonlocalized cancer, as determined by logistic regression. Patient age, geographic region, year of diagnosis and race were included as covariates. In men who would be diagnosed with prostate cancer the risk of nonlocalized cancer did not differ in those tested 2 or 3 years compared with the risk in those tested 1 year before diagnosis (relative risk 1.00, 95% confidence interval 0.84 to 1.20 and 1.02, 95% confidence interval 0.74 to 1.41, respectively). However, the risk of prostate biopsy in these men was directly related to the number of PSA tests performed (test for trend p = 0.0061). Patients who choose to undergo PSA testing may be tested on a biennial instead of annual basis without an increased risks of nonlocalized cancer. Decreasing the frequency of PSA testing may lead to fewer prostate biopsies.

PROSTATE CANCER DIAGNOSIS USING A SATURATION NEEDLE BIOPSY TECHNIQUE AFTER PREVIOUS NEGATIVE SEXTANT BIOPSIES

We hypothesized that markedly increasing the number of cores obtained during prostate needle biopsy may improve the cancer detection rate in men with persistent indications for repeat biopsy. We performed saturation ultrasound guided transrectal prostate needle biopsy in 224 men under anesthesia in an outpatient surgical setting in whom previous negative biopsies had been performed in the office. The mean number of previous sextant biopsy sessions plus or minus standard deviation before saturation biopsy was 1.8 (range 1 to 7). A mean of 23 saturation biopsy cores (range 14 to 45) were distributed throughout the whole prostate, including the peripheral, medial and anterior regions. Indications for repeat biopsy were persistent elevated serum prostate specific antigen (PSA) in 108 cases, persistent elevated PSA and abnormal rectal examination in 27, persistent abnormal rectal examination in 4, high grade prostatic intraepithelial neoplasia in the previous biopsy in 64 and atypia in the previous biopsy in 21. Cancer was detected in 77 of 224 patients (34%). The number of previous negative sextant biopsies was not predictive of subsequent cancer detection by saturation biopsy. Median PSA was 8.7 ng./ml. and median PSA velocity was 0.63 ng./ml. yearly. Of the 77 patients in whom cancer was detected radical prostatectomy was performed in 52. Pathological stage was pT2 in 48 patients and pT3 in 4, while Gleason score was 4 to 5, 6 to 7 and 8 in 5, 46 and 1, respectively. At prostatectomy median cancer volume was 1.04 cc and 85.7% of removed tumors were clinically significant, assuming a 3-year doubling time. The overall complication rate for saturation needle biopsy was 12% and hematuria requiring hospital admission was the most common event. Saturation needle biopsy of the prostate is a useful diagnostic technique in men at risk for prostate cancer with previous negative office biopsies. This technique allows adequate sampling of the whole prostate gland and has a detection rate of 34% in this cohort of patients.

EXTRAPERITONEAL ACCESS FOR KIDNEY TRANSPLANTATION IN CHILDREN WEIGHING 20 KG. OR LESS

We present our experience with kidney transplantation in children weighing 20 kg. or less. Surgery was done via extraperitoneal access while preserving the peritoneal cavity intact with special attention given to technical feasibility and the complication rate. Included in our study were 46 children with a median age of 7 years weighing 20 kg. or less (mean 16.6), of whom 16 weighed less than 15 kg. (median 13.2). The 25 boys and 21 girls underwent a total of 49 kidney transplants, including 2 in 3 during the study. Donors were living related in 44 cases and cadaveric in 5. Surgical access was obtained by making a J-shaped pararectal incision in a curvilinear fashion from the symphysis pubis to near the costal border. Mean hospital stay was 22.9 days (range 6 to 83) and mean followup was 55.8 months (range 12 to 131). All patients received water on day 1 and food on day 2 postoperatively. In 6 patients 7 surgical complications developed, including urinary fistula in 2, superficial wound infection in 2 and vascular complications in 3 (renal vein thrombosis, stenosis and renal artery kinking in 1 each). Only 1 graft was lost due to a surgical complication. There are many advantages to using extraperitoneal access without an increase in surgical complications or technical difficulty. Absent gastrointestinal complications, an easier way to perform percutaneous biopsy, treatment of any surgical complication with no need for repeat laparotomy and the possibility of using the peritoneal cavity when dialysis is needed postoperatively are attractive justifications for extraperitoneal access.

Two Concepts of Affirmative Action

MARCH 1961, LESS THAN TWO MONTHS AFTER I assuming office, President John E Kennedy issued i Executive Order 10925, establishing the Presidents Committee on Equal Employment Opportunity. Its i mission was to end discrimination in employment i by the government and its contractors. order ! required every federal contract to include the pledge that The contractor will not discriminate against any employe [e] or applicant for employment because of ; i race, creed, color, or national contractor will take affirmative action, to ensure that applicants ; ! are employed, and that employe [e] s are treated during ; ! employment, without regard to their race, creed, color, ! ; or national origin. !

Occidental College's Noble Experiment in Diversity

LESS THAN 10 miles from downtown Los Angeles, a small, selective college is choosing its students according to a simple ? but controversial ? premise: Human potential cannot be measured by mere num? bers. More than 2,000 students apply to Occidental College in Eagle Rock each year. Only two thirds make the cut ? and they are not only those with the very best grades and highest test scores. Admissions officers are far more interest? ed in applicants' personal essays, the difficulty of their high school course work, the recommendations of their teachers, and the viewpoints and experiences they will contribute to their freshman class. It is affirmative action in its broadest

Positive and negative instructions in symbolic paired comparisons with the months of the year

We investigated the semantic interpretation of positive (MORE THAN) and negative (LESS THAN) instructions in a symbolic paired comparison task with an overlearned and finite series of stimuli. French-speaking subjects were asked to indicate which member of month pairs occurred PLUS TOT (earlier), PLUS TARD (later), MOINS TOT (less early), or MOINS TARD (less late) in the year. In Experiment 1, the sign of the comparative instruction (MORE vs. LESS) was kept constant, while its attribute (EARLY vs. LATE) varied. In Experiment 2, the attribute of the instruction was kept constant, while its sign varied. The main results indicate that (1) negative instructions (with adverb LESS) yielded longer response latencies than positive ones (with adverb MORE); this difference was particularly salient on the first experimental session but, on subsequent sessions, it was reduced in Experiment 1 and neutralized in Experiment 2; (2) a symbolic-distance effect was observed on response latency and response accuracy with the four forms of the comparative instruction; (3) violations of monotonicity were noted in the symbolic-distance effect when June was used as a reference month in the analysis; (4) the serial-position effect had the form of a double-bowed curve with three stable anchor points around January, June, and December; and (5) the pattern of semantic-congruity effect with negative instructions was the exact reversal of that obtained with positive instructions; that is, if the month pairs occurred early in the year, response latencies were shorter with the instruction “less late” than with “less early,” whereas if the month pairs occurred late in the year response latencies were shorter with instruction "less early’ than with “less late.” The theoretical implications of these results for Banks' Semantic-coding model and Holyoak's Reference-point model are discussed.

ＴＤｘ‐ジベカシンキットを用いた蛍光偏光免疫測定法（ＦＰＩＡ）による硫酸アルベカシンの血中濃度測定の評価

The two methods of high performance liquid chromatography (HPLC) and bioassay have been reproted for determining arbekacin sulfate (ABK) in serum. The former method is inappropriate for clinical use due to inconvenient sample preparation, and the latter is insufficient because of its long assay time or influence of concomitant antibiotics. Therefore, the “TDx dibekacin kit” (TDx-DBK) for determination of serum arbekacin was used and evaluated in an effort to develop a practical method.The calibration curve obtained demonstrated a good correlation (r=0.9993): the regression equation was Y=0.75X+ 1.15 within the 0-10μg/ml range. The coefficient of variation of within-run precision for five concentrations of arbekacin in serum (0.5, 1.0, 2.5, 5.0, 10. 0μg/ml) was less than 5% and that of between-run precision for three concentrations (1.0, 5.0, 10.0 μg/ml) was lesst han 7%.The serum ABK (24 samples) concentrations were determined using this method and compared with those determined by HPLC. Good agreement was noted between the results derived by this TDx-DBK method and those by HPLC, where the correlation coefficient was more than 0.957. These results indicate that this TDx-DBK method may be useful for serum drug-level monitoring of patients undergoing ABK therapy.

Intersections and Differences: Integration of Women into the United States Survey Course, Part I

IN LESS THAN TWENTY YEARS women's history has become an accepted field in U.S. history.' The number of articles alone chronicles the rise of this specialty. Between 1968 and 1972, under 200 articles were published. By the 1980s, they multiplied to 700 or 800 per year. Textbooks, too, have incorporated women's history. They now generally include biographies of famous women to parallel those of famous men and women's history topics and themes like the cult of true womanhood, separate spheres, and mill women. However, even with these major changes, gender has not become a viable category in the teaching of survey courses in United States history. Textbooks provide a good indication of some of the problems in integrating women into U.S. history survey courses. Revised texts leave their basic approach to history untouched, but insert examples of women here and there.2 A picture or paragraph on Anne Hutchinson matches one on Roger Williams, or Sojourner Truth is paired with William Lloyd Garrison. This disappearing integration approach gives the impression that women and men share a common history. There is no sense that male and female public figures derived their intellectual justification from

The Sino-Vietnamese Conflict: Power Play among Communist Neighbors

IN LESS THAN TWO MONTHS-between Christmas Day of 1978 and the waning days of the Chinese New York-two wars broke out in Indochina, rocking the peace of Asia and threatening to endanger the fragile relationships between the major powers of the world. The Chinese incursions into Vietnam following Vietnam's military campaign against Cambodia were only the culmination of a series of conflicts that have poisoned the relationship between the two communist neighbors for quite some time. The purpose of this article is to analyze the origins of the Sino-Vietnamese conflict leading to the border war in early 1979 and assess the consequences of the conflict for Asia and for the relationships between the major powers.

Steroid synthesis by ovarian follicles in response to LH and PGF2alpha.

Ovarian follicles isolated from bovine ovaries at the 16th and 17th days of the estrous cycle were minced, pooled, and incubated in Krebs-Ringer bicarbonate buffer at 37degrees for 2 hr. Samples were analyzed for testosterone, estrogens, and progesterone by radioimmunoassays. Incubation alone failed to cause an increase in testosterone (12.1 vs 29.3 ng/g of tissue; P is greater than 0.05). Additions of 5 mug/ml of bovine LH or prostaglandin F2alpha caused increases in testosterone synthesis to 125.0 (Pis less than 0.01) and 103 ng/g (P is less than 0.01). Estradiol synthesis was also stimulated by LH (P is less than 0.01). However, stimulation due to addition of PGF2alpha (5.1 to 15 ng/g) was not significant (P is greater than 0.05). PGF2alpha also caused a slight but nonsignificant increase in estrone secretion. Incubation failed to increase the progesterone concentration (623 vs 774 ng/g of tissue; P is greater than 0.05). There was no increase in progesterone synthesis due to addition of either LH or PGF2alpha (P is greater than 0.05). The results show that bovine follicles produce much more testosterone than estrogen and that both LH and PGF2alpha significantly stimulate testosterone synthesis in bovine follicular tissue without increasing net progesterone biosynthesis.

ChemInform Abstract: A SIMPLE PARAMETERFREE EXPRESSION FOR THE ACTIVITY COEFFICIENT OF POTASSIUM CHLORIDE IN WATER IN THE RANGE 0,1 GREATER THAN ‐ EQUAL M LESS THAN ‐ EQUAL 4,8

Chemischer InformationsdienstVolume 6, Issue 9 Physical Inorganic Chemistry ChemInform Abstract: A SIMPLE PARAMETERFREE EXPRESSION FOR THE ACTIVITY COEFFICIENT OF POTASSIUM CHLORIDE IN WATER IN THE RANGE 0,1 GREATER THAN - EQUAL M LESS THAN - EQUAL 4,8 ERIK HOEGFELDT, ERIK HOEGFELDTSearch for more papers by this author ERIK HOEGFELDT, ERIK HOEGFELDTSearch for more papers by this author First published: March 4, 1975 https://doi.org/10.1002/chin.197509029AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume6, Issue9March 4, 1975 RelatedInformation

Decrease in the pituitary response to synthetic LH-RF in castrated rams following testosterone propionate treatment.

600 mg of testosterone propionate (TP) injected into castrated rams produced a highly significant decrease in plasma luteinizing hormone (LH (p < .01) maximal at 10-12 hours postinjection. Plasma LH then increased to preinjection levels until 72 hours when a second decrease occurred (p < .02). LH release in control animals was markedly increased 15 minutes after injection of LH-releasing hormone (LH-RH). The response to LH-RH in rams pretreated with TP was modified according to the timing of the LH-RH injection. At 6 hours post-TP injection of LH-RH produced a decreased release of LH (35% less than controls) which was significant (p < .001) in rams given 100-mcg LH-RH. It is concluded that TP pretreatment in castrated rams produces a direct inhibition of the LH-RH effect (first inhibition phase) and there may be a temporary inhibition of synthesis of LH-RH (second inhibitory phase).

Effect of oral contraceptives on the plasma concentration of pyridoxal phosphate

The plasma concentrations of pyridoxal phosphate (PLP) in 55 women who had been using oral contraceptive agents (OCA) for 6 months or more were compared with those of 77 nonusers. The PLP content was assayed enzymatically with tyrosine decarbosylase apoenzyme. Mean PLP of OCA users 7.8 plus or minus 3.7 ng/m1 was significantly lower than that for the controls 9.4 plus or minus 4.2 ng/m1 (p less than .05). Mean PLP of OCA users was significantly lower than controls in the 25-29 and 30-34 year age groups (p less than .001 and p less than .02 respectively). 10 subjects were followed sequentially from 2 weeks before OCA therapy for a duration of 3 months or more. There was a decrease in PLP in 9 of the subjects within 3 months followed by a return toward pretreatment levels in most of the subjects by 6 months. Tryptophan load tests were done concurrently with PLP measurements in 15 OCA users and 6 nonusers. In nonusers of comparable age (20-25) the xanthurenic acid (XA) excretion was 27.1 plus or minus 5.7 mcmoles/8hours. 11 of 15 OCA USERS HAD ELEVATED XANTHURENIC ACID EXCRETION (LESS THAN 38.5 15 OCA USERS HAD ELEVATED XANTHURENIC ACID EXCRETION (38.5 MCMOLES/8HOURS) BUT plasma PLP was less than 4.7 ng/m1 in only 4 of them. These results are consistent with the view that OCA induce an increased requirement for pyridoxine hydrochloride (vitamin B6). Although the majority of OCA users can correct the relative deficiency state naturally a substantial number remain deficient suggesting the need for vitamin B6 supplementation.

Collecting behavioural data

AS TRAINING IS NOTHING LESS THAN A BID TO CONTROL learning, the implication for trainers is inescapable: if we want to establish control over the learning process, then we need, as a basic requirement, to measure what is being learned in any training situation we care to design — we need to measure as best we can the behaviour changes brought about by the training. Only when we have collected such behavioural data are we in any sort of position to start focusing the training towards meeting defined individual and organisational needs.

UCG‐FINDINGS IN RELATION TO CLINICAL, HEMODYNAMIC AND SURGICAL FINDINGS – A COMPARISON BETWEEN PATIENTS WITH A RATE OF DIASTOLIC DESCENT MORE OR LESS THAN 15 mm/s.

Acta Medica ScandinavicaVolume 180, Issue s461 p. 54-68 UCG-FINDINGS IN RELATION TO CLINICAL, HEMODYNAMIC AND SURGICAL FINDINGS – A COMPARISON BETWEEN PATIENTS WITH A RATE OF DIASTOLIC DESCENT MORE OR LESS THAN 15 mm/s. First published: January/December 1966 https://doi.org/10.1111/j.0954-6820.1966.tb04762.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat Volume180, Issues461January/December 1966Pages 54-68 RelatedInformation

Policy Decisions Facing the United States in Financing and Organizing Health Care

LESS THAN A YEAR has elapsed since the Social Security Amendments of 1965 were passed. It is already evident that this law will go down in history as the most important piece of social legislation enacted in this century after the original Social Security Act of 1935. In the health field alone, the 1965 law can claim to be of first importance. Despite its limitations to the aged and to certain carefully defined categories of needy or medically needy persons, its impact on every aspect of the provision of health or medical care has already been tremendous. Its implementation is making enormous demands on the time and energies and sense of public spirit of the professions concerned, on organized suppliers of health services, on hospitals and other medical institutions, and on governmental agencies. And yet I venture to suggest that we are only at the beginning of what may well be a revolution in our methods of organizing and financing health services. After a period of digesting what was enacted in 1965, I am convinced that we shall see further action bringing us closer to the achievement of the goal so well stated by the New York Academy of Medicine that all people have the assurance of an equal opportunity to obtain a high quality of comprehensive health care. As we study the history of social legislation, one fact becomes very clear: If a new policy or program is found to be good, even though initially limited in scope, pressure will be exerted to extend it to other groups or problem areas. And this pressure will not be unduly weakened even if it emerges that a more comprehensive program costs much more than originally thought. If people are satisfied with a program, they are prepared to pay for it. In this respect and this respect only, I find myself on the side of the American Medical Association, which has always asserted that the enactment of even a modest social insurance program would be the thin edge of the wedge of further governmental action. However, we differ in our emotional response to this probability: They tremble and I rejoice.

Missiles, rockets, and space flight

LESS THAN A QUARTER of a century ago, there was no semblance of a rocket or guided missile industry; today, there exists a multibillion-dollar business employing a sizable fraction of the Nation's most skilled scientists, engineers, and technicians. This industry has brought into being, in the relatively short span of some dozen years or so, some of the most sophisticated and complex mechanical and electrical systems yet conceived by man. There exist today target-seeking missiles for military applications, and vehicles for exploring cislunar space, not to mention the highly automated ancillary devices and equipment required to support operations and missions which existed in the realm of fantasy only several decades ago.

STUDY ON THE CASTING STRUCTURE OF PURE ALUMINIUM SHEET INGOT

It is very hard in practice to get a sound sheet ingot without gases and cavities in the casting of pure aluminium. The gas content of aluminium has been hereto examined by many investigators and its contentt was recently brought to clear to be as small as less than 1c.c/100grs.The authers studied the comparative value of gas content and the porosity of 60kg's sheet ingot with 99.9%, 99.5% and 99.2% purities which were cast in book mould and direct-chill mould, and the following results have been obtained.(1) The higher the purity of aluminium, the lower the value of gas content.(2) The gas content increases towards the surface layer from its centre layer of sheet ingot.(3) The percentage of hydrogen in total gas is 64-71%.(4) The gas content of sheet ingot by C. C. P. is smaller by 50% than that of book mould process.(5) The percentage of porosity in the sheet ingot by C. C. P of 99.5% purity is lesst han 1%, on the other hand that of book mould is generally more than 3%.(6) There is no direct relation between the blister on sheet and the gas content of sheet ingot, but no blister occurs on the sheet rolled from C. C. P sheet ingot.

LESS THAN A PENNY PER MEMBER PER QUARTER

Medical Journal of AustraliaVolume 2, Issue 22 p. 781-782 Leading Article LESS THAN A PENNY PER MEMBER PER QUARTER First published: 01 November 1949 https://doi.org/10.5694/j.1326-5377.1949.tb37337.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume2, Issue22November 1949Pages 781-782 RelatedInformation

LYMPHOSARCOMA OF THE EYELID

LESS THAN 1 per cent of all lymphosarcomas originate in the region of the eye. When it does arise in the lid or the orbit, lymphosarcoma, although it infiltrates to a limited extent, tends to be a well circumscribed and slow-growing tumor; the other tissues of the body are not usually involved for many months or years. Lymphosarcoma also appears microscopically benign, with relatively well differentiated cells and few mitoses. Surgical removal may be followed by survival for many years, and irradiation has proved efficacious in ameliorating the disease for considerable periods. Cases of lymphosarcoma of the eyelid and/or orbit have recently been reported by Metivier, 1 Cookson and MacRae, 2 Michail, 3 Tooke, 4 Wheeler, 5 Jensen, 6 Siatto, 7 Hine, 8 Perera, 9 Black 10 and Rados. 11 More commonly, lymphosarcoma begins in the cervical, axillary, mediastinal or mesenteric lymph nodes, or in the lymphoid tissue of the