Background:The optimal protocol for combining high dose rate brachytherapy and external beam irradiation as treatment for localized prostate cancer is unknown. Toxicity rates and clinical and biochemical outcomes should be evaluated to validate the current treatment protocol. Methods: Fifty-eight patients were treated for prostate cancer with high dose rate brachytherapy followed by 30 Gy of external beam radiation therapy. Toxicity during treatment and for 12-18 months thereafter, and treatment-related morbidity, were evaluated. Physician-assessed treatment-related toxicity was graded at the time of occurrence using the Radiation Therapy Oncology Group morbidity criteria. Four separate self-administered questionnaires were used to collect longitudinally demographic data and general and prostate disease-related measures of quality of life. Results: Various degrees of rectal bleeding due to radiation proctitis were experienced by 13 patients (22%) at a median time of 11 months. Two of these patients needed hospitalization to undergo laser coagulation of the rectal mucosa. Study patients had statistically significant decreases in five SF-36 domains during the first month of treatment. All measures recovered by 12 months. Sexual function was not affected by irradiation. Lower urinary tract symptoms assessed by IPSS/QOL scores worsened significantly during the first month of treatment but later recovered to baseline levels. Physician-assessed RTOG scores failed to detect these changes. Conclusions: Morbidity associated with combined radiation therapy was greatest during the first month of treatment and affected quality of life significantly. Most measures recovered to baseline levels by 12 months following radiation therapy. Although the current protocol appears acceptable, measures should be taken to decrease treatment-related morbidity further. Key words: prostate cancer -high dose rate brachytherapy -external beam radiotherapy -quality of life

The purpose of this study was to assess urea kinetic modeling (UKM) as a marker for adequate dialysis in continuous ambulatory peritoneal dialysis (CAPD) patients. UKM was conducted on 19 anuric patients on CAPD for more than 2 years. Serum β2-microglobulin (β2M) was also measured as a marker of large molecular weight substances. Patient clinical conditions were evaluated by the doctors and patients as well. The patients were thus asked to complete a questionnaire on uremic symptoms an d daily activities. A comparison was made in urea kinetics and biochemical parameters based on clinical assessment scores. Patient and doctor scores showed a close correlation (r=0.69) and were correlated to days of hospitalization. The peritonitis rate was significantly higher in the “not doing well” group. No correlation could be found between indexes of UKM or β2M plasma level and clinical assessment scores. A signlficant correlation was noted between serum albumin concentration and doctor scores (r=0.52). It was thus concluded that UKM was not a good indicator of the adequacy of dialysis for CAPD, but serum albumin was. However, clinical symptoms and signs are more important than biochemical parameters for assessing adequacy.

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Intraurethral instillation of anesthetic jelly had no efficacy for reducing the pain during cystoscopy. Instillation of the jelly itself caused considerable pain, and it made pain and uncomfortable feelings after the examination worse. These results suggested that the instillation of anesthetic jelly before rigid cystoscopy in men might not be useful enough for reducing the uncomfortable feeling during the examination.

Arthritis was recognized in higher incidence than previous reports following intravesical instillation of BCG. All cases except one, diagnosed as RA, were diagnosed as reactive arthritis (Reiter's syndrome). However, correlation between HLA-B27 and arthritis was not clear in this study. Administration of steroidal drug was thought to improve arthritis in shorter duration.